| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,311 |
1,126 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
498 |
496 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
842 |
824 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
164 |
158 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
76 |
76 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
40 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
46 |
46 |
$2K |
| 90671 |
|
12 |
12 |
$890.20 |
| 81000 |
|
29 |
29 |
$103.60 |
| 81003 |
|
46 |
46 |
$77.14 |
| 90461 |
|
24 |
24 |
$35.22 |
| 96127 |
|
15 |
15 |
$23.67 |
| 3008F |
|
59 |
59 |
$0.00 |