| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,433 |
1,254 |
$79K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
160 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
95 |
88 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
375 |
347 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
31 |
$3K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
15 |
14 |
$2K |
| 90461 |
|
103 |
94 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
193 |
182 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$923.52 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
13 |
$559.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
31 |
16 |
$389.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
37 |
$382.05 |
| 82465 |
|
14 |
13 |
$313.46 |
| 96127 |
|
91 |
79 |
$253.86 |
| 99173 |
|
13 |
13 |
$21.11 |
| 90686 |
|
24 |
12 |
$0.24 |