| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,125 |
2,456 |
$195K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
239 |
209 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,313 |
1,068 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,125 |
466 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
842 |
686 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
147 |
103 |
$9K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
776 |
645 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
25 |
$2K |
| 81003 |
|
439 |
365 |
$895.97 |
| 36416 |
|
608 |
469 |
$808.61 |
| 87807 |
|
58 |
45 |
$518.42 |
| 90670 |
|
79 |
59 |
$250.93 |
| 90686 |
|
180 |
166 |
$156.42 |
| 90461 |
|
118 |
87 |
$53.45 |
| 90647 |
|
33 |
28 |
$0.00 |
| 90723 |
|
15 |
12 |
$0.00 |