| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
43 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
48 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$425.22 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$243.60 |