| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
27 |
$514.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$333.75 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
18 |
$193.68 |
| 90461 |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
15 |
$0.00 |