| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
12,614 |
8,216 |
$74K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
781 |
542 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
471 |
268 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
72 |
$1K |
| 92587 |
|
30 |
18 |
$525.24 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
20 |
13 |
$95.39 |
| 81003 |
|
47 |
39 |
$17.46 |
| 99173 |
|
30 |
18 |
$4.00 |
| 90686 |
|
64 |
52 |
$0.00 |