| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
202 |
186 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
121 |
121 |
$3K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
32 |
30 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
25 |
25 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
81 |
78 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80 |
74 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
87 |
71 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$707.96 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
45 |
44 |
$598.19 |
| 83655 |
|
34 |
34 |
$378.51 |
| 99177 |
|
17 |
17 |
$241.77 |
| 94760 |
|
62 |
56 |
$35.12 |
| 90670 |
|
15 |
14 |
$18.40 |
| 36416 |
|
45 |
42 |
$2.57 |
| 90686 |
|
18 |
18 |
$0.38 |
| 90685 |
|
29 |
29 |
$0.00 |