| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,116 |
840 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
424 |
300 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
119 |
84 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
75 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$956.71 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
34 |
25 |
$889.23 |
| 90658 |
|
19 |
15 |
$278.75 |
| 90734 |
|
13 |
13 |
$87.04 |
| 36415 |
Collection of venous blood by venipuncture |
29 |
29 |
$12.30 |
| 90461 |
|
43 |
27 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
244 |
148 |
$0.00 |