| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,009 |
929 |
$86K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
256 |
254 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
124 |
124 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$245.40 |
| 81002 |
|
32 |
32 |
$85.93 |