| Code | Description | Claims | Beneficiaries | Total Paid |
| 99233 |
Prolong inpt eval add15 m |
273 |
197 |
$20K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
324 |
160 |
$14K |
| 99223 |
Prolong inpt eval add15 m |
113 |
111 |
$13K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
192 |
188 |
$9K |
| 99222 |
Initial hospital care, per day, moderate complexity |
14 |
13 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
14 |
14 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
14 |
14 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
14 |
$0.00 |