| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
202 |
192 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
231 |
214 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
60 |
60 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$3K |
| 90461 |
|
83 |
83 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
129 |
129 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
214 |
214 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
14 |
13 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
29 |
28 |
$870.54 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
99 |
99 |
$725.22 |
| 80061 |
Lipid panel |
37 |
37 |
$429.57 |
| 81003 |
|
169 |
168 |
$310.55 |
| 36415 |
Collection of venous blood by venipuncture |
139 |
139 |
$281.17 |
| 94760 |
|
82 |
79 |
$0.00 |
| 90686 |
|
19 |
19 |
$0.00 |