| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,309 |
2,942 |
$272K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
760 |
704 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
139 |
139 |
$10K |
| 92567 |
|
525 |
523 |
$7K |
| 92587 |
|
276 |
274 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
42 |
42 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
235 |
233 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$2K |
| 90461 |
|
80 |
80 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
73 |
72 |
$231.07 |
| 90686 |
|
139 |
136 |
$227.52 |
| 99173 |
|
208 |
205 |
$176.37 |
| 83655 |
|
17 |
17 |
$171.65 |
| 90648 |
|
14 |
14 |
$0.00 |
| 3725F |
|
64 |
64 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
51 |
51 |
$0.00 |