| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
611 |
579 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
373 |
355 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
147 |
147 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
122 |
122 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
85 |
83 |
$8K |
| 90461 |
|
170 |
170 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
260 |
260 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
198 |
97 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
147 |
142 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$2K |
| 99051 |
|
77 |
73 |
$924.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
103 |
100 |
$693.19 |
| 83655 |
|
28 |
28 |
$293.72 |
| 99174 |
|
39 |
39 |
$212.55 |
| 99188 |
|
12 |
12 |
$194.40 |
| 81002 |
|
54 |
51 |
$140.92 |
| 90686 |
|
70 |
70 |
$0.00 |
| 90723 |
|
35 |
35 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 92551 |
|
53 |
53 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90648 |
|
58 |
58 |
$0.00 |
| 90633 |
|
58 |
58 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90670 |
|
71 |
71 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |