| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
102 |
97 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$3K |
| 90461 |
|
47 |
47 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
96 |
96 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
36 |
36 |
$355.50 |
| 85018 |
|
48 |
48 |
$98.40 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90686 |
|
33 |
33 |
$0.00 |