| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
25 |
$444.90 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
161 |
105 |
$339.62 |
| 84443 |
Thyroid stimulating hormone (TSH) |
13 |
13 |
$18.30 |
| 84480 |
|
13 |
13 |
$15.00 |
| 84439 |
|
13 |
13 |
$10.00 |
| 80076 |
|
12 |
12 |
$7.00 |
| 84550 |
|
12 |
12 |
$3.00 |
| 80061 |
Lipid panel |
13 |
13 |
$0.00 |
| 83721 |
|
13 |
13 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
13 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
13 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
12 |
12 |
$0.00 |