| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,920 |
1,629 |
$122K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
88 |
84 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90686 |
|
55 |
46 |
$909.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$406.56 |
| 90656 |
|
19 |
14 |
$390.63 |
| 84443 |
Thyroid stimulating hormone (TSH) |
18 |
13 |
$278.14 |
| 80053 |
Comprehensive metabolic panel |
20 |
15 |
$199.29 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
15 |
$103.32 |