| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83 |
76 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
237 |
87 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
33 |
30 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
14 |
$130.24 |
| 90686 |
|
20 |
18 |
$0.00 |