| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
495 |
444 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
24 |
$3K |
| 90686 |
|
89 |
89 |
$608.98 |
| 99173 |
|
59 |
58 |
$384.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
208 |
205 |
$155.38 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| 92587 |
|
31 |
31 |
$0.00 |