| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,083 |
3,631 |
$391K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,795 |
1,636 |
$116K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
931 |
859 |
$62K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
570 |
560 |
$38K |
| 90670 |
|
622 |
606 |
$12K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
998 |
937 |
$9K |
| 90680 |
|
437 |
424 |
$8K |
| 90698 |
|
349 |
348 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
84 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
432 |
197 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
278 |
257 |
$3K |
| 90658 |
|
162 |
157 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
62 |
60 |
$3K |
| 90633 |
|
74 |
73 |
$1K |
| 90655 |
|
64 |
63 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$840.00 |
| 90651 |
|
38 |
36 |
$692.65 |
| 92015 |
Determination of refractive state |
60 |
59 |
$525.61 |
| 87807 |
|
15 |
15 |
$165.00 |
| 81002 |
|
12 |
12 |
$36.00 |
| 36416 |
|
14 |
12 |
$30.00 |