| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
262 |
241 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
20 |
20 |
$1K |
| 84153 |
|
35 |
35 |
$559.04 |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$434.18 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
328 |
295 |
$288.63 |
| 80053 |
Comprehensive metabolic panel |
174 |
167 |
$100.09 |
| 99233 |
Prolong inpt eval add15 m |
17 |
12 |
$37.65 |
| 36415 |
Collection of venous blood by venipuncture |
207 |
186 |
$23.59 |
| 83735 |
|
16 |
16 |
$6.37 |
| 83615 |
|
14 |
14 |
$5.74 |
| 84100 |
|
30 |
30 |
$4.50 |
| 84550 |
|
14 |
14 |
$4.29 |
| 83540 |
|
12 |
12 |
$0.00 |
| 83550 |
|
12 |
12 |
$0.00 |
| 82728 |
|
12 |
12 |
$0.00 |