| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
939 |
841 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
321 |
297 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
212 |
212 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
186 |
186 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
125 |
125 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
80 |
78 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
465 |
457 |
$8K |
| 4124F |
|
155 |
153 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
130 |
127 |
$2K |
| 96127 |
|
194 |
194 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
193 |
187 |
$753.02 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$38.04 |
| 90686 |
|
36 |
36 |
$34.06 |
| 90744 |
|
38 |
38 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 90670 |
|
74 |
74 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |