| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
28 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$2K |
| 90688 |
|
46 |
39 |
$907.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
113 |
104 |
$806.26 |
| 99173 |
|
12 |
12 |
$31.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
246 |
127 |
$0.00 |
| 90461 |
|
26 |
26 |
$0.00 |