| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
152 |
151 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
24 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
99 |
99 |
$727.55 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
102 |
90 |
$389.87 |
| 99051 |
|
18 |
18 |
$223.83 |
| 90686 |
|
35 |
35 |
$191.97 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$188.90 |
| 99177 |
|
12 |
12 |
$0.00 |