| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,799 |
1,653 |
$133K |
| 99493 |
|
500 |
500 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,733 |
1,121 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
153 |
153 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
228 |
227 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
120 |
$10K |
| 92587 |
|
675 |
675 |
$9K |
| 99492 |
|
70 |
70 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
113 |
109 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
309 |
298 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
26 |
$1K |
| 0002A |
|
23 |
23 |
$896.78 |
| 36415 |
Collection of venous blood by venipuncture |
682 |
678 |
$619.20 |
| 0072A |
|
14 |
14 |
$560.00 |
| 0071A |
|
13 |
13 |
$520.00 |
| 0001A |
|
14 |
14 |
$490.82 |
| 96127 |
|
104 |
104 |
$379.83 |
| 99173 |
|
410 |
410 |
$312.58 |
| 90461 |
|
122 |
116 |
$91.74 |
| 97803 |
|
48 |
48 |
$68.24 |
| 90677 |
|
16 |
16 |
$0.00 |
| 90686 |
|
59 |
59 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 99080 |
|
81 |
27 |
$0.00 |
| 91300 |
|
13 |
13 |
$0.00 |