| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
475 |
429 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
226 |
208 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
166 |
76 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
122 |
115 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
19 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$524.11 |
| 81001 |
|
58 |
56 |
$210.82 |
| 90686 |
|
30 |
29 |
$155.75 |
| 87999 |
|
83 |
76 |
$2.76 |