| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,761 |
3,099 |
$273K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,918 |
1,543 |
$86K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
155 |
113 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
135 |
106 |
$8K |
| 90686 |
|
373 |
265 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
34 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
31 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
14 |
$2K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
12 |
12 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$1K |
| 90674 |
|
34 |
24 |
$862.59 |
| 90656 |
|
34 |
27 |
$664.88 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
131 |
47 |
$375.70 |
| 90670 |
|
12 |
12 |
$307.24 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
13 |
$283.77 |
| 90688 |
|
14 |
13 |
$217.66 |
| 90633 |
|
13 |
12 |
$116.19 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
16 |
$0.00 |
| 1036F |
|
254 |
236 |
$0.00 |
| 1126F |
|
74 |
68 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
57 |
31 |
$0.00 |
| 3008F |
|
47 |
43 |
$0.00 |
| 3074F |
|
51 |
47 |
$0.00 |
| 1125F |
|
14 |
13 |
$0.00 |
| 1160F |
|
81 |
60 |
$0.00 |
| 3078F |
|
38 |
36 |
$0.00 |
| 1159F |
|
46 |
42 |
$0.00 |
| 3725F |
|
17 |
16 |
$0.00 |