| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
408 |
353 |
$7K |
| 99223 |
Prolong inpt eval add15 m |
24 |
14 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
76 |
66 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
119 |
112 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
65 |
39 |
$358.84 |
| 80053 |
Comprehensive metabolic panel |
45 |
30 |
$340.35 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$328.90 |
| 82728 |
|
22 |
13 |
$86.78 |