| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
917 |
787 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
62 |
57 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
44 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
222 |
192 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
30 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
220 |
195 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
23 |
17 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
181 |
163 |
$1K |
| 92551 |
|
171 |
131 |
$1K |
| 90686 |
|
111 |
98 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$988.91 |
| 99177 |
|
244 |
208 |
$976.57 |
| 87081 |
|
162 |
144 |
$908.94 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
66 |
31 |
$836.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
50 |
45 |
$631.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
315 |
287 |
$514.34 |
| 99188 |
|
12 |
12 |
$260.63 |
| 90461 |
|
69 |
60 |
$216.95 |
| 80061 |
Lipid panel |
26 |
17 |
$162.40 |
| 36416 |
|
305 |
253 |
$93.11 |
| 99173 |
|
31 |
20 |
$46.62 |
| 99000 |
|
31 |
26 |
$3.86 |
| 94760 |
|
255 |
216 |
$2.82 |
| 99051 |
|
15 |
13 |
$0.00 |