| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,693 |
1,330 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
744 |
644 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
428 |
244 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
271 |
228 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
717 |
619 |
$4K |
| 94760 |
|
2,469 |
1,898 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
36 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
40 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
167 |
130 |
$2K |
| 92551 |
|
288 |
245 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
158 |
135 |
$1K |
| 81002 |
|
555 |
472 |
$1K |
| 96127 |
|
216 |
146 |
$1K |
| 99173 |
|
238 |
210 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
12 |
$884.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
55 |
32 |
$832.98 |
| 3008F |
|
810 |
672 |
$780.00 |
| 36415 |
Collection of venous blood by venipuncture |
501 |
415 |
$721.96 |
| 36416 |
|
331 |
280 |
$493.67 |
| 90688 |
|
51 |
42 |
$291.98 |
| 1160F |
|
47 |
36 |
$250.00 |
| 1159F |
|
48 |
37 |
$250.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
12 |
$128.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$36.86 |
| 90734 |
|
16 |
12 |
$0.00 |
| 99000 |
|
68 |
64 |
$0.00 |
| 90620 |
|
20 |
15 |
$0.00 |