| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
856 |
783 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
520 |
487 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
254 |
254 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
281 |
279 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
455 |
453 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
747 |
744 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
135 |
135 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
291 |
276 |
$8K |
| 83655 |
|
554 |
553 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
867 |
847 |
$6K |
| 80061 |
Lipid panel |
423 |
423 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
205 |
201 |
$3K |
| 86580 |
|
383 |
383 |
$2K |
| 81000 |
|
401 |
397 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$1K |
| 87070 |
|
128 |
127 |
$1K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
104 |
102 |
$798.81 |
| 90474 |
|
45 |
45 |
$763.20 |
| 99173 |
|
62 |
62 |
$155.40 |
| 90686 |
|
145 |
145 |
$15.00 |
| 90700 |
|
255 |
255 |
$0.00 |
| 90713 |
|
276 |
276 |
$0.00 |
| 96160 |
|
226 |
226 |
$0.00 |
| 90648 |
|
198 |
198 |
$0.00 |
| 90670 |
|
183 |
183 |
$0.00 |
| 90685 |
|
16 |
16 |
$0.00 |
| 90707 |
|
26 |
26 |
$0.00 |
| 90680 |
|
50 |
50 |
$0.00 |
| 90716 |
|
51 |
51 |
$0.00 |
| 90744 |
|
17 |
17 |
$0.00 |