| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54 |
49 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
118 |
$624.36 |
| 90686 |
|
41 |
40 |
$559.92 |
| 99177 |
|
13 |
13 |
$302.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$158.25 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$0.00 |