| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
934 |
883 |
$69K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
279 |
274 |
$21K |
| 99215 |
Prolong outpt/office vis |
92 |
86 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
106 |
105 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
74 |
$4K |
| 93000 |
|
201 |
197 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
15 |
15 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
15 |
15 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
18 |
18 |
$731.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
65 |
$695.06 |
| 80061 |
Lipid panel |
15 |
15 |
$453.25 |
| 80053 |
Comprehensive metabolic panel |
17 |
17 |
$292.84 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
15 |
$217.09 |
| 96127 |
|
73 |
72 |
$196.71 |
| 1036F |
|
193 |
176 |
$0.50 |