| Code | Description | Claims | Beneficiaries | Total Paid |
| 87081 |
|
447 |
435 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
40 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
83 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
190 |
180 |
$2K |
| 80061 |
Lipid panel |
92 |
88 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18 |
18 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
17 |
17 |
$988.61 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
45 |
45 |
$764.65 |
| 85027 |
|
34 |
34 |
$505.92 |
| 83655 |
|
13 |
13 |
$362.31 |
| 84443 |
Thyroid stimulating hormone (TSH) |
15 |
15 |
$354.64 |
| 84165 |
|
14 |
14 |
$317.65 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45 |
44 |
$210.29 |
| 83735 |
|
97 |
94 |
$190.98 |
| 80051 |
|
98 |
95 |
$154.78 |
| 85651 |
|
30 |
29 |
$95.06 |
| 82565 |
|
87 |
84 |
$67.04 |
| 84100 |
|
12 |
12 |
$65.16 |
| 84520 |
|
12 |
12 |
$54.48 |
| 83970 |
|
13 |
12 |
$30.09 |
| ATP03 |
|
856 |
850 |
$27.40 |
| 82310 |
|
55 |
54 |
$18.77 |
| 81001 |
|
12 |
12 |
$14.60 |
| 82040 |
|
55 |
54 |
$13.20 |
| ATP14 |
|
874 |
858 |
$0.00 |
| ATP04 |
|
530 |
526 |
$0.00 |
| ATP15 |
|
208 |
206 |
$0.00 |
| ATP17 |
|
615 |
614 |
$0.00 |
| ATP09 |
|
304 |
302 |
$0.00 |
| ATP10 |
|
135 |
131 |
$0.00 |
| ATP11 |
|
481 |
481 |
$0.00 |
| ATP12 |
|
173 |
173 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
22 |
22 |
$0.00 |
| ATP05 |
|
467 |
455 |
$0.00 |
| ATP18 |
|
154 |
154 |
$0.00 |
| ATP06 |
|
266 |
265 |
$0.00 |
| ATP02 |
|
369 |
367 |
$0.00 |
| ATP08 |
|
1,399 |
1,343 |
$0.00 |
| ATP07 |
|
391 |
381 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
13 |
13 |
$0.00 |