| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
617 |
463 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
169 |
167 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
30 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
87 |
$949.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
90 |
86 |
$243.12 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
118 |
115 |
$50.49 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
137 |
121 |
$19.35 |
| 86317 |
|
137 |
122 |
$17.55 |
| 87070 |
|
137 |
121 |
$10.08 |
| 87184 |
|
137 |
122 |
$8.76 |
| 36415 |
Collection of venous blood by venipuncture |
31 |
31 |
$0.00 |
| 99000 |
|
132 |
127 |
$0.00 |
| 36416 |
|
59 |
57 |
$0.00 |