| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,419 |
1,799 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
351 |
302 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
413 |
339 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
283 |
224 |
$22K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
89 |
86 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
78 |
$8K |
| 99199 |
Unlisted special service, procedure or report |
1,690 |
1,682 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
12 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
70 |
$754.64 |
| 36415 |
Collection of venous blood by venipuncture |
206 |
133 |
$368.69 |
| 90670 |
|
18 |
12 |
$239.74 |
| 92551 |
|
52 |
49 |
$201.25 |
| 99173 |
|
62 |
57 |
$61.62 |
| 96127 |
|
12 |
12 |
$42.10 |
| 90677 |
|
70 |
68 |
$0.00 |
| 90661 |
|
17 |
17 |
$0.00 |