| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,705 |
1,364 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,095 |
924 |
$55K |
| T2003 |
Non-emergency transportation; encounter/trip |
4,921 |
349 |
$44K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
404 |
352 |
$33K |
| A0130 |
Non-emergency transportation: wheelchair van |
526 |
133 |
$11K |
| 99442 |
|
286 |
204 |
$10K |
| 99385 |
|
27 |
26 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
54 |
$2K |
| 99386 |
|
31 |
18 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$868.06 |
| 36415 |
Collection of venous blood by venipuncture |
214 |
193 |
$364.87 |
| A0100 |
Non-emergency transportation; taxi |
29 |
13 |
$310.00 |
| 99441 |
|
14 |
12 |
$292.64 |
| 99000 |
|
170 |
153 |
$125.12 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
49 |
46 |
$116.52 |
| 84443 |
Thyroid stimulating hormone (TSH) |
16 |
15 |
$84.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
15 |
$46.62 |
| 80061 |
Lipid panel |
30 |
29 |
$26.78 |
| 81003 |
|
33 |
29 |
$25.20 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
13 |
$24.08 |
| 80053 |
Comprehensive metabolic panel |
15 |
15 |
$10.56 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
32 |
30 |
$0.00 |
| 82746 |
|
12 |
12 |
$0.00 |
| 1160F |
|
37 |
32 |
$0.00 |