| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,725 |
3,397 |
$176K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,254 |
1,166 |
$95K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
259 |
246 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
891 |
804 |
$3K |
| 90686 |
|
173 |
167 |
$1K |
| 90688 |
|
136 |
126 |
$828.07 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
14 |
13 |
$267.76 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$92.79 |
| 99188 |
|
13 |
12 |
$65.65 |
| G0008 |
Administration of influenza virus vaccine |
15 |
14 |
$0.00 |
| X5622 |
|
37 |
37 |
$0.00 |