| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
317 |
294 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
189 |
173 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
64 |
62 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
223 |
210 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
71 |
71 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
82 |
80 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
94 |
93 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
79 |
76 |
$615.42 |
| 90473 |
|
33 |
33 |
$559.68 |