| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
440 |
436 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
888 |
815 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
342 |
321 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$522.65 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$306.84 |
| 36415 |
Collection of venous blood by venipuncture |
331 |
328 |
$83.08 |
| 3008F |
|
892 |
872 |
$0.00 |
| G9230 |
Chlamydia, gonorrhea, and syphilis not screened, reason not given |
22 |
22 |
$0.00 |
| 92579 |
|
13 |
13 |
$0.00 |
| 3725F |
|
23 |
23 |
$0.00 |