| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
163 |
156 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
106 |
105 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
236 |
234 |
$651.70 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$442.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
39 |
$365.94 |
| 99173 |
|
80 |
80 |
$325.00 |
| 92587 |
|
14 |
14 |
$252.69 |
| 36415 |
Collection of venous blood by venipuncture |
97 |
96 |
$102.00 |
| 90686 |
|
61 |
61 |
$20.03 |
| 92552 |
|
12 |
12 |
$0.00 |