| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
919 |
794 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,872 |
659 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
131 |
126 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
67 |
$5K |
| 90461 |
|
326 |
284 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$97.68 |
| 90670 |
|
58 |
56 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90686 |
|
55 |
55 |
$0.00 |
| 90677 |
|
53 |
51 |
$0.00 |