| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 85027 |
|
142 |
142 |
$1K |
| 83655 |
|
40 |
40 |
$538.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
202 |
193 |
$69.24 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
36 |
36 |
$10.79 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
105 |
101 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
143 |
143 |
$0.00 |
| 90680 |
|
71 |
71 |
$0.00 |
| 90723 |
|
70 |
70 |
$0.00 |
| 99000 |
|
207 |
204 |
$0.00 |
| 90686 |
|
126 |
126 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
34 |
34 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
340 |
340 |
$0.00 |
| 80061 |
Lipid panel |
35 |
35 |
$0.00 |
| 90670 |
|
80 |
80 |
$0.00 |
| 90648 |
|
84 |
84 |
$0.00 |
| 90461 |
|
133 |
133 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
112 |
112 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
130 |
126 |
$0.00 |
| 99173 |
|
70 |
70 |
$0.00 |
| 86689 |
|
12 |
12 |
$0.00 |
| 81002 |
|
40 |
40 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
35 |
35 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
60 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |