| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
84 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
81 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
101 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
35 |
$3K |
| 90461 |
|
78 |
77 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
92 |
91 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
66 |
63 |
$463.25 |
| 83655 |
|
40 |
40 |
$419.60 |
| 99188 |
|
13 |
13 |
$210.60 |
| 99174 |
|
34 |
34 |
$185.30 |
| 81002 |
|
19 |
18 |
$51.49 |
| 90723 |
|
26 |
26 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 92551 |
|
50 |
50 |
$0.00 |
| 90648 |
|
35 |
35 |
$0.00 |
| 90633 |
|
34 |
34 |
$0.00 |
| 90670 |
|
39 |
39 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |