| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
963 |
865 |
$42K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
386 |
384 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
204 |
200 |
$3K |
| 96111 |
|
68 |
68 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$1K |
| 90686 |
|
12 |
12 |
$220.15 |
| 94760 |
|
97 |
97 |
$0.00 |