| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
187 |
177 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
52 |
47 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 97802 |
|
44 |
44 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
54 |
$668.33 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
82 |
79 |
$536.47 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
27 |
$348.03 |
| 90461 |
|
15 |
15 |
$290.03 |
| 99188 |
|
14 |
14 |
$226.80 |
| 96127 |
|
18 |
18 |
$127.98 |
| 87070 |
|
14 |
13 |
$96.98 |