| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97 |
94 |
$373.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$38.60 |
| 0071A |
|
33 |
33 |
$21.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
85 |
85 |
$13.72 |
| 90633 |
|
13 |
13 |
$0.00 |
| 99188 |
|
32 |
30 |
$0.00 |
| 90473 |
|
14 |
14 |
$0.00 |
| X5622 |
|
77 |
77 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
27 |
$0.00 |
| 99173 |
|
58 |
58 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
31 |
$0.00 |
| 90660 |
|
14 |
14 |
$0.00 |
| 90686 |
|
67 |
67 |
$0.00 |
| 96127 |
|
76 |
75 |
$0.00 |
| 92551 |
|
58 |
58 |
$0.00 |
| 85018 |
|
64 |
64 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
64 |
64 |
$0.00 |