| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
65 |
64 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
106 |
79 |
$776.41 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
114 |
106 |
$575.31 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
64 |
$60.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$1.17 |