| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
690 |
610 |
$44K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
563 |
508 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$984.87 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
141 |
134 |
$885.22 |
| 99050 |
|
19 |
17 |
$705.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
39 |
$425.01 |
| 87081 |
|
41 |
39 |
$216.45 |
| 90686 |
|
54 |
54 |
$27.00 |