| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
844 |
798 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
264 |
263 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
45 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
38 |
$2K |
| 90461 |
|
135 |
134 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87430 |
|
26 |
26 |
$355.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$5.69 |
| 90688 |
|
40 |
40 |
$0.00 |
| 90633 |
|
19 |
19 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |