| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,901 |
1,704 |
$73K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
206 |
206 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
377 |
370 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
55 |
55 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
475 |
451 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$900.57 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$747.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
104 |
$743.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$662.41 |
| 90686 |
|
101 |
100 |
$463.94 |
| 81025 |
|
12 |
12 |
$74.15 |
| 85018 |
|
28 |
28 |
$48.79 |
| 3074F |
|
508 |
472 |
$0.00 |
| 3079F |
|
29 |
25 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90734 |
|
14 |
13 |
$0.00 |
| 3078F |
|
507 |
473 |
$0.00 |
| 90670 |
|
27 |
27 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 3077F |
|
37 |
35 |
$0.00 |