| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
375 |
300 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
635 |
205 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$951.36 |
| 90461 |
|
139 |
118 |
$925.98 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12 |
12 |
$711.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
25 |
$235.80 |