| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,827 |
1,630 |
$113K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
675 |
642 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
449 |
435 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
116 |
116 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
680 |
675 |
$2K |
| 90688 |
|
102 |
102 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
78 |
78 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$903.17 |
| 92587 |
|
33 |
33 |
$800.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$799.68 |
| 99188 |
|
12 |
12 |
$230.00 |
| 90461 |
|
13 |
13 |
$140.00 |
| 96161 |
|
18 |
18 |
$30.34 |
| 99000 |
|
732 |
721 |
$4.50 |
| G0008 |
Administration of influenza virus vaccine |
34 |
34 |
$0.00 |