| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
123 |
119 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20 |
20 |
$3K |
| 90837 |
Psychotherapy, 53 minutes with patient |
20 |
14 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
62 |
62 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
19 |
19 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
48 |
$100.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
90 |
89 |
$20.00 |
| 90688 |
|
24 |
24 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |