| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56 |
52 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
70 |
$1K |
| 90688 |
|
20 |
20 |
$0.00 |
| 90686 |
|
15 |
15 |
$0.00 |
| 90658 |
|
15 |
15 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
20 |
13 |
$0.00 |