| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
492 |
454 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
55 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
72 |
70 |
$663.45 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
47 |
46 |
$652.11 |
| 92551 |
|
28 |
28 |
$295.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$247.30 |
| 99177 |
|
48 |
48 |
$241.63 |
| 87081 |
|
28 |
27 |
$193.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31 |
31 |
$66.36 |
| 99051 |
|
163 |
156 |
$60.00 |
| 36416 |
|
71 |
70 |
$17.55 |
| 94760 |
|
45 |
44 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |