| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
101 |
98 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
146 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
54 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
29 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
98 |
98 |
$1K |
| 90461 |
|
52 |
52 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
23 |
22 |
$48.99 |
| 85018 |
|
22 |
22 |
$43.05 |
| 90686 |
|
14 |
14 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |