| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
371 |
289 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
36 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
29 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
127 |
80 |
$598.26 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$312.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
87 |
82 |
$191.49 |
| 90461 |
|
17 |
15 |
$112.54 |
| 97803 |
|
35 |
31 |
$50.00 |
| 81002 |
|
81 |
79 |
$39.71 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$30.14 |
| 87081 |
|
61 |
58 |
$14.85 |
| 85018 |
|
57 |
56 |
$13.14 |
| 36416 |
|
84 |
77 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
39 |
35 |
$0.00 |
| 92551 |
|
44 |
40 |
$0.00 |
| 90698 |
|
15 |
12 |
$0.00 |
| 90744 |
|
19 |
14 |
$0.00 |
| 90670 |
|
15 |
12 |
$0.00 |
| 99173 |
|
30 |
29 |
$0.00 |