| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
112 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
23 |
12 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
40 |
37 |
$633.57 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
44 |
$0.00 |