| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
454 |
392 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
116 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
38 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
77 |
50 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$967.66 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
57 |
54 |
$467.17 |
| 81003 |
|
132 |
119 |
$331.61 |
| 90651 |
|
12 |
12 |
$300.35 |
| 36415 |
Collection of venous blood by venipuncture |
119 |
103 |
$251.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$173.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
158 |
144 |
$152.18 |
| 99173 |
|
61 |
58 |
$149.26 |
| 90633 |
|
12 |
12 |
$135.30 |
| 99000 |
|
88 |
74 |
$62.56 |
| 96127 |
|
16 |
14 |
$49.96 |
| 94760 |
|
112 |
106 |
$10.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
51 |
$10.30 |