| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
704 |
573 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
127 |
117 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
191 |
152 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
25 |
$788.42 |
| 90688 |
|
15 |
15 |
$330.00 |