| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
407 |
403 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
226 |
220 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
15 |
$949.32 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
66 |
$325.02 |
| A4550 |
Surgical trays |
14 |
14 |
$58.00 |
| 81003 |
|
93 |
92 |
$39.15 |
| 99070 |
|
95 |
92 |
$8.35 |
| 81025 |
|
15 |
15 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
17 |
15 |
$0.00 |