| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114 |
55 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
264 |
150 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
119 |
81 |
$748.30 |
| 90686 |
|
157 |
125 |
$487.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
157 |
93 |
$198.23 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$86.06 |
| 99173 |
|
326 |
237 |
$77.14 |
| 36415 |
Collection of venous blood by venipuncture |
163 |
123 |
$35.79 |
| 96160 |
|
107 |
76 |
$32.48 |
| 99000 |
|
181 |
138 |
$5.95 |
| 99072 |
|
183 |
162 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
33 |
$0.00 |
| 90688 |
|
30 |
27 |
$0.00 |