| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
718 |
685 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
331 |
309 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
306 |
306 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
169 |
168 |
$13K |
| 90670 |
|
255 |
255 |
$3K |
| 90648 |
|
250 |
250 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
181 |
94 |
$3K |
| 83655 |
|
161 |
161 |
$2K |
| 90723 |
|
190 |
190 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
112 |
112 |
$2K |
| 90686 |
|
100 |
100 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90633 |
|
87 |
87 |
$966.95 |
| 81003 |
|
354 |
346 |
$949.19 |
| 85014 |
|
286 |
286 |
$815.04 |
| 90681 |
|
52 |
52 |
$592.45 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
41 |
38 |
$378.40 |
| 90685 |
|
18 |
18 |
$202.40 |
| 90696 |
|
13 |
13 |
$160.10 |
| 90710 |
|
12 |
12 |
$149.10 |
| 90716 |
|
12 |
12 |
$135.30 |
| 90707 |
|
12 |
12 |
$135.30 |
| 90700 |
|
12 |
12 |
$121.00 |