| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,339 |
1,220 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
216 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
64 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
53 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
93 |
89 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$1K |
| 90686 |
|
127 |
119 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
21 |
$595.17 |
| 90670 |
|
44 |
44 |
$508.70 |
| 87081 |
|
59 |
58 |
$474.36 |
| 81001 |
|
102 |
98 |
$344.33 |
| 90648 |
|
26 |
26 |
$303.09 |
| 86580 |
|
54 |
52 |
$290.31 |
| 85018 |
|
93 |
90 |
$254.27 |
| 85014 |
|
93 |
90 |
$253.85 |
| 90633 |
|
16 |
16 |
$172.70 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16 |
14 |
$147.84 |
| 90651 |
|
12 |
12 |
$137.50 |