| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
224 |
222 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
38 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$196.90 |
| 90686 |
|
24 |
24 |
$0.00 |
| 99072 |
|
83 |
82 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |