| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,466 |
1,236 |
$102K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
206 |
195 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
64 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
20 |
$2K |
| 87400 |
|
122 |
55 |
$788.42 |
| 80053 |
Comprehensive metabolic panel |
136 |
129 |
$751.92 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
195 |
182 |
$501.25 |
| 84443 |
Thyroid stimulating hormone (TSH) |
26 |
26 |
$240.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$178.15 |
| 36415 |
Collection of venous blood by venipuncture |
159 |
142 |
$0.00 |