| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,864 |
1,641 |
$61K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,496 |
1,478 |
$29K |
| 92552 |
|
310 |
310 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
159 |
$4K |
| 92567 |
|
282 |
282 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$946.05 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
76 |
75 |
$466.44 |
| 81003 |
|
155 |
152 |
$307.19 |
| 92587 |
|
12 |
12 |
$278.57 |
| 96127 |
|
81 |
81 |
$223.15 |
| 99173 |
|
187 |
187 |
$160.47 |
| 92551 |
|
34 |
30 |
$93.44 |
| 90685 |
|
34 |
34 |
$61.68 |
| 99051 |
|
13 |
13 |
$57.27 |
| 96160 |
|
40 |
39 |
$48.95 |
| 90686 |
|
24 |
24 |
$19.03 |
| 94760 |
|
14 |
12 |
$2.44 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
38 |
38 |
$0.00 |
| 36416 |
|
76 |
75 |
$0.00 |
| 99000 |
|
18 |
18 |
$0.00 |
| 97802 |
|
30 |
28 |
$0.00 |
| 97803 |
|
129 |
124 |
$0.00 |