| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97 |
89 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
65 |
65 |
$819.65 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
32 |
$305.73 |
| 96127 |
|
13 |
13 |
$92.43 |
| 85018 |
|
34 |
34 |
$69.70 |
| 90686 |
|
12 |
12 |
$0.00 |