| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
394 |
359 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
438 |
363 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
43 |
43 |
$3K |
| 97802 |
|
46 |
46 |
$637.35 |
| 90686 |
|
18 |
18 |
$441.66 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$149.15 |
| 86701 |
|
19 |
19 |
$15.80 |
| 84443 |
Thyroid stimulating hormone (TSH) |
19 |
19 |
$14.76 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17 |
17 |
$13.50 |
| 86592 |
|
22 |
22 |
$7.60 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
64 |
64 |
$0.00 |
| 3008F |
|
37 |
37 |
$0.00 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
16 |
16 |
$0.00 |
| 99401 |
|
12 |
12 |
$0.00 |