| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
180 |
177 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
239 |
200 |
$726.89 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$114.16 |
| 36415 |
Collection of venous blood by venipuncture |
249 |
244 |
$73.88 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
30 |
$68.46 |
| 90658 |
|
31 |
31 |
$0.00 |