| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,015 |
1,796 |
$23K |
| 0001A |
|
321 |
316 |
$12K |
| 0002A |
|
286 |
283 |
$12K |
| 90670 |
|
488 |
425 |
$7K |
| 0012A |
|
138 |
138 |
$5K |
| 0011A |
|
142 |
142 |
$4K |
| 90686 |
|
303 |
258 |
$4K |
| 0013A |
|
62 |
61 |
$3K |
| 90677 |
|
77 |
75 |
$1K |
| 0031A |
|
19 |
19 |
$800.66 |
| 90633 |
|
62 |
44 |
$786.33 |
| 0004A |
|
12 |
12 |
$505.68 |
| 90648 |
|
43 |
38 |
$422.10 |
| 90734 |
|
36 |
35 |
$415.98 |
| 90715 |
|
17 |
16 |
$284.07 |
| 90619 |
|
16 |
16 |
$267.36 |
| 90707 |
|
12 |
12 |
$200.52 |
| 90680 |
|
12 |
12 |
$200.52 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$192.96 |
| 90656 |
|
12 |
12 |
$188.81 |
| 36415 |
Collection of venous blood by venipuncture |
34 |
18 |
$139.40 |
| 36416 |
|
14 |
14 |
$57.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
12 |
$0.00 |