| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
386 |
341 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
98 |
98 |
$978.73 |
| 90461 |
|
54 |
54 |
$807.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
32 |
$329.92 |
| 99051 |
|
17 |
17 |
$163.20 |
| 81003 |
|
97 |
95 |
$148.80 |
| 85014 |
|
85 |
85 |
$139.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25 |
24 |
$134.75 |
| 90670 |
|
15 |
15 |
$0.00 |