| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,495 |
3,173 |
$244K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,680 |
3,400 |
$182K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
345 |
343 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
848 |
786 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
225 |
215 |
$3K |
| 90686 |
|
174 |
168 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
27 |
26 |
$267.76 |
| 90688 |
|
58 |
58 |
$237.94 |
| 92551 |
|
15 |
14 |
$110.70 |
| 99173 |
|
15 |
14 |
$23.20 |
| X5622 |
|
25 |
25 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
54 |
54 |
$0.00 |