| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
853 |
731 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
315 |
314 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
494 |
491 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
64 |
64 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
46 |
46 |
$786.86 |
| 90461 |
|
14 |
14 |
$234.80 |
| 81003 |
|
53 |
53 |
$67.64 |
| 3008F |
|
56 |
56 |
$0.00 |