| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
315 |
277 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
78 |
$4K |
| 99051 |
|
126 |
112 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$987.12 |
| 90461 |
|
62 |
62 |
$968.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
82 |
82 |
$827.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
56 |
54 |
$577.36 |
| 80061 |
Lipid panel |
25 |
25 |
$232.25 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
36 |
36 |
$194.04 |
| 85014 |
|
79 |
79 |
$129.56 |
| 81003 |
|
76 |
76 |
$117.80 |
| 36415 |
Collection of venous blood by venipuncture |
26 |
26 |
$44.20 |