| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
823 |
755 |
$56K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
53 |
51 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
439 |
435 |
$755.31 |
| 90686 |
|
100 |
100 |
$720.31 |
| 90698 |
|
13 |
13 |
$229.62 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
81 |
81 |
$158.25 |
| 99177 |
|
73 |
73 |
$147.24 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
195 |
178 |
$0.00 |