| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
815 |
688 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
31 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
162 |
137 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
126 |
60 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
16 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
158 |
144 |
$1K |
| 92551 |
|
118 |
95 |
$975.00 |
| 90686 |
|
75 |
60 |
$736.92 |
| 99177 |
|
160 |
138 |
$638.71 |
| 80061 |
Lipid panel |
42 |
36 |
$600.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
48 |
40 |
$491.34 |
| 87081 |
|
62 |
55 |
$441.44 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
54 |
44 |
$404.16 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
212 |
178 |
$277.20 |
| 90461 |
|
44 |
34 |
$138.60 |
| 36416 |
|
198 |
159 |
$6.51 |
| 94760 |
|
116 |
101 |
$0.00 |