| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
349 |
335 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
59 |
56 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$952.72 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$832.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
58 |
$574.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$159.49 |
| 90686 |
|
27 |
26 |
$0.00 |