| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
170 |
141 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
80 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
65 |
55 |
$537.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
13 |
$281.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
21 |
16 |
$277.80 |