| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
81 |
78 |
$0.00 |
| 99442 |
|
515 |
494 |
$0.00 |
| 80061 |
Lipid panel |
746 |
741 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
183 |
183 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
114 |
111 |
$0.00 |
| 86703 |
|
12 |
12 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
722 |
663 |
$0.00 |
| 3078F |
|
828 |
752 |
$0.00 |
| G9920 |
Screening performed and negative |
71 |
71 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
121 |
121 |
$0.00 |
| D1120 |
Prophylaxis - child |
32 |
32 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
59 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
41 |
41 |
$0.00 |
| D0350 |
|
25 |
25 |
$0.00 |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
23 |
22 |
$0.00 |
| 90686 |
|
117 |
117 |
$0.00 |
| 99441 |
|
117 |
115 |
$0.00 |
| 96161 |
|
30 |
30 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
518 |
509 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
534 |
532 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
58 |
58 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,071 |
1,011 |
$0.00 |
| 3044F |
|
184 |
183 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
575 |
561 |
$0.00 |
| 1111F |
|
264 |
238 |
$0.00 |
| 3074F |
|
859 |
778 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
765 |
761 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,890 |
1,773 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
279 |
272 |
$0.00 |
| 3079F |
|
30 |
28 |
$0.00 |
| 85027 |
|
141 |
139 |
$0.00 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
34 |
34 |
$0.00 |
| 90651 |
|
62 |
62 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
26 |
26 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$0.00 |
| 90656 |
|
34 |
34 |
$0.00 |
| 70300 |
|
28 |
28 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
14 |
14 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$0.00 |
| D1330 |
|
43 |
43 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
18 |
18 |
$0.00 |