| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
202 |
201 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
30 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$537.06 |
| 90461 |
|
12 |
12 |
$521.55 |
| 99072 |
|
50 |
50 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90686 |
|
16 |
16 |
$0.00 |