| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,266 |
2,027 |
$146K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
117 |
117 |
$2K |
| 90682 |
|
91 |
91 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$2K |
| 99051 |
|
113 |
108 |
$2K |
| 96127 |
|
145 |
144 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
28 |
$742.46 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
46 |
45 |
$512.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
50 |
49 |
$498.00 |
| 36415 |
Collection of venous blood by venipuncture |
175 |
166 |
$325.44 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$88.10 |
| 99000 |
|
68 |
60 |
$1.10 |