| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
209 |
198 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
171 |
163 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
51 |
51 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
151 |
151 |
$2K |
| 90461 |
|
63 |
63 |
$1K |
| 87430 |
|
58 |
58 |
$608.42 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
16 |
$371.88 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
67 |
65 |
$361.13 |
| 99071 |
|
13 |
13 |
$37.83 |
| 97802 |
|
95 |
95 |
$0.00 |
| 90686 |
|
42 |
42 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
118 |
118 |
$0.00 |