| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,224 |
3,754 |
$946K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
879 |
553 |
$120K |
| X5622 |
|
216 |
198 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
188 |
89 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
42 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
12 |
$292.70 |
| 36415 |
Collection of venous blood by venipuncture |
927 |
526 |
$160.19 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
431 |
220 |
$115.61 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
138 |
74 |
$21.14 |
| 96127 |
|
518 |
247 |
$4.06 |
| 99188 |
|
149 |
72 |
$0.00 |
| 90461 |
|
25 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
214 |
105 |
$0.00 |
| 99173 |
|
119 |
69 |
$0.00 |
| 92551 |
|
121 |
69 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
174 |
90 |
$0.00 |
| 90686 |
|
56 |
23 |
$0.00 |
| 90656 |
|
38 |
23 |
$0.00 |