| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,217 |
1,839 |
$162K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
308 |
244 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
597 |
579 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
60 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 99401 |
|
29 |
25 |
$653.49 |
| 36415 |
Collection of venous blood by venipuncture |
332 |
327 |
$276.01 |
| 90461 |
|
14 |
14 |
$183.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$63.72 |
| 90686 |
|
13 |
13 |
$0.00 |