| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,026 |
915 |
$49K |
| 96127 |
|
852 |
745 |
$14K |
| 96160 |
|
803 |
721 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
108 |
91 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
100 |
92 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
238 |
215 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
51 |
$6K |
| 90686 |
|
381 |
335 |
$4K |
| 94010 |
|
108 |
63 |
$4K |
| 94664 |
|
176 |
98 |
$2K |
| 99173 |
|
266 |
241 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$1K |
| 95012 |
|
109 |
62 |
$767.66 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
38 |
38 |
$461.94 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
14 |
$353.71 |
| 90651 |
|
33 |
25 |
$211.20 |
| 36415 |
Collection of venous blood by venipuncture |
40 |
29 |
$164.00 |
| 90734 |
|
16 |
14 |
$102.40 |
| 85018 |
|
36 |
25 |
$83.52 |
| 94760 |
|
38 |
31 |
$20.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
196 |
170 |
$0.00 |