| Code | Description | Claims | Bene. Records | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
106 |
94 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
28 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
89 |
81 |
$374.56 |
| 80053 |
Comprehensive metabolic panel |
12 |
12 |
$52.80 |
| 36415 |
Collection of venous blood by venipuncture |
84 |
71 |
$0.00 |