| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,442 |
4,027 |
$77K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,342 |
1,342 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,668 |
2,638 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,174 |
1,173 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,158 |
1,072 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
643 |
642 |
$15K |
| 97802 |
|
3,585 |
3,584 |
$8K |
| 92081 |
|
379 |
379 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
4,014 |
3,954 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
53 |
$2K |
| 90473 |
|
494 |
491 |
$1K |
| 83655 |
|
319 |
319 |
$845.07 |
| 99406 |
|
1,690 |
1,690 |
$766.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
40 |
38 |
$517.59 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$352.59 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
39 |
39 |
$248.94 |
| 99408 |
|
1,156 |
1,156 |
$166.85 |
| 90686 |
|
426 |
426 |
$153.74 |
| 36400 |
|
24 |
24 |
$140.90 |
| 90672 |
|
413 |
411 |
$99.60 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
262 |
262 |
$9.20 |
| 87110 |
|
1,213 |
1,212 |
$8.44 |
| 90734 |
|
131 |
131 |
$0.00 |
| 90633 |
|
71 |
71 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 1220F |
|
1,383 |
1,383 |
$0.00 |
| 4293F |
|
1,383 |
1,383 |
$0.00 |
| 90651 |
|
137 |
137 |
$0.00 |