| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,780 |
5,352 |
$322K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
886 |
886 |
$66K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,848 |
1,825 |
$55K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,434 |
1,390 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
682 |
682 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
720 |
703 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
357 |
357 |
$30K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
921 |
880 |
$26K |
| 92551 |
|
2,033 |
2,033 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,768 |
2,683 |
$17K |
| 87070 |
|
2,415 |
2,347 |
$16K |
| 87184 |
|
2,416 |
2,347 |
$13K |
| 96127 |
|
1,546 |
1,073 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
105 |
105 |
$7K |
| 85018 |
|
2,642 |
2,641 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
52 |
52 |
$4K |
| 99173 |
|
1,326 |
1,326 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
437 |
431 |
$3K |
| 69210 |
|
50 |
50 |
$3K |
| 92557 |
|
34 |
34 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
356 |
337 |
$1K |
| 96160 |
|
531 |
531 |
$926.79 |
| 99050 |
|
49 |
49 |
$796.22 |
| 83655 |
|
30 |
30 |
$188.40 |
| 99188 |
|
13 |
13 |
$183.30 |
| 36415 |
Collection of venous blood by venipuncture |
63 |
63 |
$96.39 |
| 81002 |
|
12 |
12 |
$25.08 |
| 36416 |
|
1,844 |
1,816 |
$9.83 |
| 99000 |
|
63 |
63 |
$0.00 |
| 94760 |
|
16 |
14 |
$0.00 |