| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
567 |
565 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
555 |
553 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
212 |
178 |
$1K |
| 87806 |
|
25 |
25 |
$655.25 |
| A4267 |
Contraceptive supply, condom, male, each |
25 |
24 |
$298.25 |
| 36415 |
Collection of venous blood by venipuncture |
779 |
758 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,266 |
742 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
381 |
381 |
$0.00 |
| 99441 |
|
32 |
29 |
$0.00 |
| 86593 |
|
449 |
447 |
$0.00 |
| 87536 |
|
145 |
145 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
969 |
956 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
177 |
175 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
619 |
615 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
12 |
12 |
$0.00 |
| 81001 |
|
293 |
291 |
$0.00 |
| 86706 |
|
134 |
134 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22 |
14 |
$0.00 |
| 87522 |
Neg quan hep c or qual rna |
226 |
225 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
28 |
15 |
$0.00 |
| 87340 |
|
106 |
106 |
$0.00 |
| 88187 |
|
148 |
148 |
$0.00 |
| 81015 |
|
12 |
12 |
$0.00 |
| 85027 |
|
30 |
30 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
62 |
62 |
$0.00 |
| 88142 |
|
12 |
12 |
$0.00 |
| 1220F |
|
12 |
12 |
$0.00 |
| 99443 |
|
20 |
19 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,278 |
690 |
$0.00 |
| 80061 |
Lipid panel |
418 |
418 |
$0.00 |
| 86705 |
|
104 |
104 |
$0.00 |
| 86703 |
|
105 |
105 |
$0.00 |
| 86708 |
|
16 |
16 |
$0.00 |
| 90653 |
|
12 |
12 |
$0.00 |
| 86480 |
|
28 |
28 |
$0.00 |
| 99442 |
|
28 |
27 |
$0.00 |
| 82248 |
|
50 |
50 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
16 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
63 |
33 |
$0.00 |