| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,121 |
1,005 |
$72K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
448 |
432 |
$22K |
| 90461 |
|
132 |
128 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
449 |
431 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
27 |
$3K |
| 90670 |
|
12 |
12 |
$3K |
| 99177 |
|
100 |
96 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
148 |
68 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$923.78 |
| 81002 |
|
75 |
74 |
$187.92 |