| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
23 |
$548.73 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
19 |
$65.44 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$0.00 |
| 96160 |
|
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
17 |
$0.00 |
| 96127 |
|
24 |
24 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
12 |
$0.00 |