| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,255 |
1,109 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
749 |
746 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
180 |
180 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
154 |
132 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
41 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
80 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
43 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
78 |
$728.28 |
| 99188 |
|
52 |
52 |
$360.36 |
| D0190 |
|
17 |
17 |
$253.13 |
| 96161 |
|
203 |
194 |
$221.98 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
14 |
$111.16 |
| 36416 |
|
16 |
16 |
$78.00 |
| 99072 |
|
286 |
254 |
$0.00 |
| 90685 |
|
29 |
29 |
$0.00 |
| 99177 |
|
12 |
12 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 99000 |
|
43 |
40 |
$0.00 |
| 90686 |
|
168 |
168 |
$0.00 |
| 90688 |
|
42 |
42 |
$0.00 |