| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,077 |
994 |
$85K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
59 |
58 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
244 |
153 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
24 |
$3K |
| 90461 |
|
50 |
25 |
$771.14 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27 |
27 |
$476.30 |
| 99050 |
|
17 |
17 |
$423.07 |
| 99401 |
|
15 |
15 |
$418.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$140.19 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$116.57 |
| 90686 |
|
86 |
39 |
$43.00 |