| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
985 |
567 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
451 |
295 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
200 |
106 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
164 |
45 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$891.22 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
107 |
63 |
$813.88 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
23 |
12 |
$255.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
62 |
42 |
$221.56 |
| 81003 |
|
157 |
88 |
$126.92 |
| 93000 |
|
14 |
12 |
$108.18 |
| 81025 |
|
20 |
13 |
$71.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
12 |
$70.30 |
| 90715 |
|
23 |
16 |
$52.88 |
| 36415 |
Collection of venous blood by venipuncture |
56 |
29 |
$44.76 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16 |
13 |
$32.63 |
| 90686 |
|
18 |
14 |
$19.03 |
| 90649 |
|
24 |
18 |
$0.00 |