| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,376 |
1,117 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
418 |
356 |
$15K |
| 90686 |
|
38 |
33 |
$227.50 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27 |
27 |
$104.14 |
| 90688 |
|
12 |
12 |
$48.00 |
| 81003 |
|
28 |
28 |
$27.09 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
19 |
$26.20 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$3.13 |
| 85004 |
|
14 |
13 |
$0.00 |
| 4004F |
|
15 |
13 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
12 |
12 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
27 |
25 |
$0.00 |