| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
688 |
628 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
90 |
88 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
68 |
67 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
341 |
320 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
609 |
389 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
55 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
461 |
445 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
87 |
48 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87650 |
|
18 |
17 |
$385.32 |
| 81000 |
|
115 |
114 |
$360.61 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90670 |
|
28 |
27 |
$0.00 |
| 90700 |
|
15 |
14 |
$0.00 |
| 90461 |
|
101 |
93 |
$0.00 |
| 97802 |
|
69 |
69 |
$0.00 |