| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,686 |
3,928 |
$260K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,122 |
1,053 |
$24K |
| 90461 |
|
317 |
295 |
$10K |
| 92552 |
|
572 |
531 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
101 |
91 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
81 |
75 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
55 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
142 |
131 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$919.51 |
| 90473 |
|
75 |
59 |
$823.68 |
| 81002 |
|
301 |
273 |
$655.45 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$623.28 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
50 |
$623.13 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
24 |
$418.50 |
| 99051 |
|
14 |
12 |
$275.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$269.91 |
| 96127 |
|
53 |
45 |
$172.91 |
| 81005 |
|
77 |
74 |
$143.69 |
| 99173 |
|
63 |
63 |
$136.64 |
| 90686 |
|
158 |
148 |
$78.00 |
| 90685 |
|
14 |
14 |
$7.00 |
| 90672 |
|
12 |
12 |
$5.50 |