| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,710 |
1,478 |
$104K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
694 |
645 |
$27K |
| 90480 |
|
99 |
86 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
26 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
28 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
174 |
161 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
107 |
97 |
$2K |
| 90686 |
|
258 |
229 |
$2K |
| 0071A |
|
34 |
21 |
$1K |
| 0072A |
|
20 |
20 |
$1K |
| 91320 |
|
14 |
12 |
$668.60 |
| 96127 |
|
55 |
54 |
$578.56 |
| 90656 |
|
92 |
88 |
$422.35 |
| 90688 |
|
68 |
67 |
$358.04 |
| 36415 |
Collection of venous blood by venipuncture |
27 |
26 |
$69.00 |
| 90461 |
|
12 |
12 |
$0.00 |