| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
13 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
121 |
102 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
16 |
$683.13 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
102 |
$647.14 |
| 36415 |
Collection of venous blood by venipuncture |
98 |
78 |
$18.90 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
89 |
74 |
$0.00 |
| 36416 |
|
38 |
26 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
24 |
16 |
$0.00 |
| 99000 |
|
141 |
111 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
23 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
14 |
$0.00 |