| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,762 |
1,653 |
$98K |
| 86592 |
|
4,045 |
3,865 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
4,195 |
4,038 |
$10K |
| 86580 |
|
1,703 |
1,419 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
993 |
956 |
$7K |
| 99442 |
|
75 |
71 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
235 |
206 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
61 |
50 |
$3K |
| 90715 |
|
134 |
132 |
$2K |
| 90633 |
|
159 |
158 |
$2K |
| 91322 |
|
14 |
13 |
$1K |
| 99441 |
|
46 |
42 |
$1K |
| 90710 |
|
60 |
59 |
$995.89 |
| 90707 |
|
37 |
35 |
$986.12 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$890.69 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
295 |
288 |
$849.34 |
| 90744 |
|
49 |
48 |
$746.64 |
| 99201 |
|
27 |
24 |
$619.13 |
| 90480 |
|
30 |
29 |
$558.00 |
| 90696 |
|
14 |
14 |
$263.52 |
| 90674 |
|
13 |
13 |
$263.52 |
| 90651 |
|
14 |
14 |
$236.09 |
| 90661 |
|
13 |
13 |
$229.56 |
| 90686 |
|
16 |
16 |
$198.96 |
| 87081 |
|
37 |
26 |
$134.25 |
| 90713 |
|
20 |
20 |
$110.91 |
| D0191 |
|
136 |
136 |
$0.00 |
| T1017 |
Targeted case management, each 15 minutes |
23 |
16 |
$0.00 |
| D1351 |
Sealant - per tooth |
120 |
43 |
$0.00 |