| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,658 |
1,403 |
$79K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
170 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
96 |
87 |
$7K |
| 90677 |
|
103 |
95 |
$5K |
| 90698 |
|
119 |
100 |
$2K |
| 90686 |
|
123 |
103 |
$2K |
| 90680 |
|
47 |
41 |
$816.29 |
| 90744 |
|
27 |
27 |
$466.60 |
| 36415 |
Collection of venous blood by venipuncture |
26 |
25 |
$13.68 |
| 1036F |
|
252 |
205 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
18 |
$0.00 |
| 4004F |
|
15 |
13 |
$0.00 |