| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,525 |
2,431 |
$181K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
484 |
378 |
$43K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
475 |
357 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,564 |
833 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
969 |
717 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
331 |
218 |
$1K |
| 92552 |
|
82 |
82 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
109 |
103 |
$490.29 |
| 86580 |
|
306 |
248 |
$392.14 |
| 81002 |
|
326 |
317 |
$263.44 |
| 99173 |
|
72 |
72 |
$88.42 |
| 90670 |
|
14 |
14 |
$58.27 |
| 90700 |
|
13 |
13 |
$30.00 |
| 36415 |
Collection of venous blood by venipuncture |
124 |
68 |
$6.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
975 |
159 |
$0.55 |
| 90461 |
|
261 |
45 |
$0.00 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
13 |
13 |
$0.00 |
| A4215 |
Needle, sterile, any size, each |
30 |
30 |
$0.00 |
| 90647 |
|
14 |
14 |
$0.00 |
| 99000 |
|
103 |
15 |
$0.00 |