| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
155 |
153 |
$910.22 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
155 |
153 |
$907.30 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
121 |
79 |
$462.74 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,135 |
1,006 |
$379.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$139.86 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
693 |
607 |
$137.44 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
560 |
500 |
$75.00 |
| 86592 |
|
53 |
53 |
$12.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
207 |
206 |
$4.46 |
| 80061 |
Lipid panel |
866 |
860 |
$0.00 |
| 82540 |
|
196 |
193 |
$0.00 |
| 99442 |
|
327 |
316 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 86703 |
|
317 |
317 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
582 |
557 |
$0.00 |
| 99441 |
|
260 |
255 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
1,064 |
1,019 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,875 |
1,747 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,001 |
991 |
$0.00 |
| 1220F |
|
731 |
704 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
79 |
79 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
65 |
64 |
$0.00 |
| 82043 |
|
196 |
193 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26 |
25 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
53 |
53 |
$0.00 |
| 87340 |
|
24 |
24 |
$0.00 |
| 86780 |
|
117 |
116 |
$0.00 |
| 81001 |
|
12 |
12 |
$0.00 |
| 82607 |
|
25 |
25 |
$0.00 |
| 90686 |
|
83 |
83 |
$0.00 |
| 99443 |
|
17 |
14 |
$0.00 |