| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
464 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
82 |
74 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
74 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
60 |
58 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
45 |
$6K |
| 90461 |
|
112 |
112 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
158 |
158 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
57 |
57 |
$866.32 |
| 81000 |
|
99 |
96 |
$377.00 |
| 85018 |
|
140 |
140 |
$339.48 |
| 96160 |
|
29 |
28 |
$293.10 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
28 |
26 |
$226.24 |
| 92551 |
|
101 |
101 |
$9.13 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90670 |
|
48 |
48 |
$0.00 |
| 90700 |
|
26 |
26 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |