| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,902 |
2,655 |
$24K |
| 90649 |
|
96 |
96 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
243 |
237 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
250 |
250 |
$6K |
| 92551 |
|
713 |
709 |
$4K |
| 90658 |
|
403 |
402 |
$2K |
| 90733 |
|
15 |
15 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41 |
39 |
$665.03 |
| 90715 |
|
12 |
12 |
$437.28 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$371.30 |
| 81000 |
|
87 |
87 |
$181.10 |
| 80053 |
Comprehensive metabolic panel |
15 |
15 |
$137.85 |
| 85018 |
|
71 |
71 |
$91.33 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
708 |
703 |
$66.42 |
| 36415 |
Collection of venous blood by venipuncture |
80 |
80 |
$53.50 |
| 99000 |
|
38 |
38 |
$46.67 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
53 |
$23.99 |
| 99173 |
|
728 |
724 |
$12.09 |
| 81002 |
|
12 |
12 |
$2.15 |
| 99384 |
|
27 |
27 |
$0.00 |
| 99383 |
|
18 |
18 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
160 |
160 |
$0.00 |
| 90734 |
|
17 |
17 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |