| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,158 |
937 |
$81K |
| 93975 |
|
24 |
24 |
$6K |
| 84403 |
|
120 |
120 |
$3K |
| 84402 |
|
121 |
121 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
28 |
28 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
34 |
33 |
$2K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
90 |
90 |
$2K |
| 84270 |
|
117 |
117 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
48 |
47 |
$2K |
| 82670 |
|
45 |
45 |
$1K |
| 84153 |
|
62 |
61 |
$975.20 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
107 |
101 |
$574.98 |
| 82627 |
|
16 |
16 |
$333.60 |
| 86769 |
|
15 |
15 |
$300.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$126.23 |