| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
865 |
789 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
659 |
652 |
$25K |
| 92551 |
|
259 |
257 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$999.12 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$896.05 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$853.25 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$767.09 |
| 99173 |
|
218 |
216 |
$352.85 |
| 36415 |
Collection of venous blood by venipuncture |
37 |
37 |
$46.80 |
| 90686 |
|
17 |
17 |
$35.70 |