| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
226 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
94 |
93 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
26 |
$356.50 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
49 |
$350.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
18 |
$300.00 |
| 90734 |
|
12 |
12 |
$157.35 |
| 92552 |
|
90 |
89 |
$150.00 |
| 90656 |
|
25 |
25 |
$15.67 |
| 36415 |
Collection of venous blood by venipuncture |
54 |
53 |
$3.96 |