| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,698 |
1,528 |
$107K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
116 |
109 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
77 |
69 |
$5K |
| 90671 |
|
41 |
39 |
$4K |
| 90686 |
|
173 |
172 |
$2K |
| 92552 |
|
83 |
79 |
$2K |
| 91320 |
|
14 |
13 |
$1K |
| 87428 |
|
47 |
45 |
$1K |
| 90656 |
|
60 |
60 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$851.62 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$540.29 |
| 36415 |
Collection of venous blood by venipuncture |
296 |
268 |
$485.59 |
| 3008F |
|
123 |
117 |
$450.00 |
| 90677 |
|
13 |
12 |
$420.66 |
| 99000 |
|
652 |
580 |
$345.92 |
| 99173 |
|
114 |
110 |
$242.06 |
| 90633 |
|
13 |
13 |
$190.18 |
| 94760 |
|
2,401 |
2,066 |
$186.23 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
557 |
538 |
$174.20 |
| 90480 |
|
14 |
13 |
$160.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
315 |
224 |
$128.00 |