| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,888 |
1,617 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
125 |
107 |
$8K |
| 90686 |
|
105 |
87 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
14 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$1K |
| 90651 |
|
14 |
12 |
$526.70 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
38 |
$60.00 |
| 36415 |
Collection of venous blood by venipuncture |
26 |
24 |
$0.00 |
| 3017F |
|
87 |
75 |
$0.00 |
| 1036F |
|
639 |
559 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 4004F |
|
73 |
66 |
$0.00 |