| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
890 |
784 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
196 |
189 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
700 |
613 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
130 |
128 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
94 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
385 |
366 |
$3K |
| 90461 |
|
129 |
116 |
$2K |
| 81003 |
|
316 |
309 |
$410.63 |
| 90656 |
|
20 |
20 |
$100.00 |
| 96160 |
|
54 |
53 |
$19.04 |
| 36415 |
Collection of venous blood by venipuncture |
73 |
67 |
$6.00 |
| 96127 |
|
27 |
27 |
$0.00 |
| 81000 |
|
12 |
12 |
$0.00 |
| 90686 |
|
15 |
15 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
12 |
12 |
$0.00 |