| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
187 |
172 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
100 |
84 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
29 |
$341.56 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
41 |
24 |
$134.47 |
| 96127 |
|
16 |
12 |
$128.46 |
| 90686 |
|
20 |
18 |
$63.00 |
| 99000 |
|
50 |
46 |
$0.00 |
| 90461 |
|
34 |
29 |
$0.00 |