| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96127 |
|
479 |
472 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
228 |
154 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
37 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
91 |
91 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
89 |
88 |
$977.50 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
117 |
112 |
$499.20 |
| 92551 |
|
81 |
81 |
$497.64 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
27 |
$80.00 |
| 90686 |
|
137 |
135 |
$38.06 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
14 |
$6.34 |
| 80061 |
Lipid panel |
12 |
12 |
$6.04 |
| 99072 |
|
161 |
156 |
$0.00 |
| 99051 |
|
13 |
13 |
$0.00 |