| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
709 |
636 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
362 |
308 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
234 |
206 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
96 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
200 |
189 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$987.93 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$203.28 |
| 90686 |
|
108 |
100 |
$0.00 |
| 90677 |
|
24 |
24 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |
| 90670 |
|
17 |
14 |
$0.00 |