| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,016 |
1,928 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
275 |
275 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
229 |
224 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
55 |
$6K |
| 90461 |
|
191 |
189 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,599 |
2,407 |
$3K |
| 90686 |
|
652 |
652 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,023 |
1,942 |
$753.09 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
768 |
744 |
$482.31 |
| 90734 |
|
24 |
24 |
$460.22 |
| 36415 |
Collection of venous blood by venipuncture |
67 |
66 |
$441.31 |
| 99173 |
|
1,341 |
1,292 |
$389.78 |
| 3008F |
|
67 |
63 |
$314.40 |
| 90651 |
|
26 |
26 |
$98.00 |
| 90620 |
|
12 |
12 |
$56.00 |