| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
63 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
16 |
$798.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
28 |
$439.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$170.04 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
28 |
$128.25 |