| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,539 |
2,719 |
$219K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,254 |
1,052 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
24 |
24 |
$2K |
| 96127 |
|
55 |
55 |
$585.39 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
14 |
$286.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$133.51 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
14 |
14 |
$126.70 |
| 36415 |
Collection of venous blood by venipuncture |
51 |
50 |
$110.20 |