| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,387 |
1,266 |
$53K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,156 |
600 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
111 |
111 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
66 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$4K |
| 99429 |
|
84 |
84 |
$3K |
| 90461 |
|
83 |
68 |
$689.12 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
69 |
$582.25 |
| 90686 |
|
306 |
293 |
$0.00 |