| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
557 |
529 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
398 |
389 |
$2K |
| 90672 |
|
61 |
61 |
$426.42 |
| 99177 |
|
67 |
67 |
$406.78 |
| 90686 |
|
47 |
46 |
$278.97 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
83 |
82 |
$173.25 |
| 90473 |
|
54 |
54 |
$159.58 |
| 90698 |
|
13 |
13 |
$158.10 |
| 90670 |
|
13 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
113 |
112 |
$0.00 |
| 90474 |
|
14 |
14 |
$0.00 |