| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| U0004 |
Cov-19 test non-cdc hgh thru |
4,652 |
3,411 |
$354K |
| G2023 |
Specimen collect covid-19 |
3,534 |
2,716 |
$88K |
| 99214 |
|
1,297 |
1,007 |
$79K |
| U0005 |
Infec agen detec ampli probe |
2,390 |
1,906 |
$60K |
| 99285 |
|
858 |
820 |
$47K |
| 99204 |
|
547 |
434 |
$36K |
| 99284 |
|
814 |
761 |
$33K |
| 99291 |
|
238 |
38 |
$31K |
| 99203 |
|
849 |
623 |
$31K |
| 99283 |
|
976 |
923 |
$29K |
| 99213 |
|
515 |
418 |
$21K |
| 87426 |
|
554 |
428 |
$19K |
| U0003 |
Cov-19 amp prb hgh thruput |
166 |
124 |
$13K |
| 99385 |
|
167 |
118 |
$13K |
| 99233 |
Prolong inpt eval add15 m |
390 |
96 |
$9K |
| 99386 |
|
62 |
55 |
$5K |
| 99383 |
|
59 |
49 |
$4K |
| U0002 |
Covid-19 lab test non-cdc |
68 |
56 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
43 |
39 |
$3K |
| 99384 |
|
33 |
32 |
$2K |
| A4927 |
Non-sterile gloves |
381 |
303 |
$2K |
| 99395 |
|
15 |
12 |
$1K |
| 87804 |
|
34 |
34 |
$751.20 |
| 99282 |
|
12 |
12 |
$266.20 |
| 99072 |
|
39 |
22 |
$75.00 |
| A4245 |
Alcohol wipes per box |
161 |
115 |
$0.00 |
| A4928 |
Surgical mask |
163 |
116 |
$0.00 |
| S5175 |
Laundry serv,ext,prof,/order |
163 |
116 |
$0.00 |
| E0700 |
Safety equipment |
163 |
116 |
$0.00 |
| A9270 |
Non-covered item or service |
160 |
115 |
$0.00 |