| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,656 |
1,562 |
$128K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
409 |
401 |
$23K |
| 96127 |
|
177 |
176 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
37 |
37 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$715.75 |
| 90686 |
|
17 |
17 |
$262.50 |
| 90688 |
|
17 |
17 |
$262.50 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
26 |
26 |
$235.30 |
| 36415 |
Collection of venous blood by venipuncture |
102 |
98 |
$211.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
13 |
$148.92 |