| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
73 |
68 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$2K |
| 0031A |
|
23 |
23 |
$957.49 |
| 0002A |
|
22 |
19 |
$915.86 |
| 0001A |
|
20 |
20 |
$829.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$155.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$123.24 |
| 90686 |
|
28 |
14 |
$14.00 |