| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
158 |
$358.50 |
| 81002 |
|
12 |
12 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
24 |
24 |
$0.00 |
| 86592 |
|
12 |
12 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
26 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$0.00 |