| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,647 |
5,296 |
$260K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,961 |
4,863 |
$109K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
948 |
940 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
955 |
951 |
$59K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
770 |
761 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
503 |
476 |
$28K |
| 90461 |
|
845 |
832 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
162 |
159 |
$10K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,267 |
1,266 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
3,761 |
3,718 |
$7K |
| 36406 |
|
88 |
87 |
$1K |
| 90686 |
|
913 |
885 |
$941.00 |
| 36400 |
|
39 |
39 |
$425.64 |
| 90671 |
|
12 |
12 |
$9.00 |
| 90707 |
|
17 |
16 |
$3.00 |
| 90713 |
|
16 |
14 |
$3.00 |
| 90651 |
|
80 |
78 |
$3.00 |
| 90734 |
|
26 |
25 |
$2.00 |
| 90670 |
|
16 |
15 |
$1.00 |
| 90700 |
|
19 |
17 |
$1.00 |
| 90716 |
|
15 |
14 |
$1.00 |
| 90710 |
|
14 |
12 |
$0.00 |
| 99000 |
|
27 |
25 |
$0.00 |