| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57 |
47 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
66 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
18 |
$848.52 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
76 |
74 |
$500.40 |
| 3008F |
|
51 |
42 |
$150.00 |
| 92551 |
|
15 |
14 |
$100.24 |
| 99173 |
|
27 |
26 |
$57.39 |
| 90686 |
|
13 |
13 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
31 |
28 |
$0.00 |
| 99072 |
|
13 |
12 |
$0.00 |
| 90658 |
|
38 |
34 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
12 |
12 |
$0.00 |