| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
900 |
809 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
443 |
412 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
200 |
191 |
$7K |
| 99401 |
|
156 |
154 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41 |
40 |
$3K |
| 87428 |
|
54 |
54 |
$2K |
| 92552 |
|
58 |
54 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
13 |
$1K |
| 85018 |
|
424 |
414 |
$772.49 |
| 90461 |
|
38 |
30 |
$528.00 |
| 81002 |
|
106 |
100 |
$303.40 |
| 86580 |
|
30 |
27 |
$219.76 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
13 |
$55.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
107 |
92 |
$0.00 |
| 90686 |
|
53 |
48 |
$0.00 |
| 99072 |
|
76 |
67 |
$0.00 |