| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72 |
69 |
$112.92 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
309 |
286 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
96 |
94 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
25 |
25 |
$0.00 |
| 96127 |
|
24 |
24 |
$0.00 |