| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
169 |
166 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
349 |
348 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
70 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
22 |
22 |
$2K |
| 90461 |
|
12 |
12 |
$398.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$145.73 |
| 97802 |
|
39 |
39 |
$0.00 |
| 3008F |
|
38 |
38 |
$0.00 |
| 90686 |
|
17 |
17 |
$0.00 |