| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
150 |
148 |
$614.29 |
| 90686 |
|
41 |
41 |
$217.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
49 |
42 |
$147.24 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |
| 99177 |
|
36 |
36 |
$0.00 |