| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
308 |
280 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
85 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
316 |
307 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
62 |
62 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
39 |
$770.50 |
| 92587 |
|
27 |
27 |
$675.00 |
| 96127 |
|
43 |
36 |
$126.84 |
| 99072 |
|
55 |
53 |
$0.00 |