| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
43 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
146 |
123 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
170 |
138 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$921.86 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$737.11 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
16 |
$298.43 |
| 90686 |
|
57 |
39 |
$0.00 |
| 90688 |
|
15 |
13 |
$0.00 |