| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
719 |
682 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
840 |
824 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
422 |
416 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,148 |
1,568 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
88 |
86 |
$2K |
| 90461 |
|
2,934 |
828 |
$859.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
131 |
87 |
$73.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
81 |
$31.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
46 |
$15.71 |
| 90670 |
|
529 |
517 |
$0.00 |
| 90648 |
|
262 |
259 |
$0.00 |
| 90633 |
|
194 |
187 |
$0.00 |
| 90661 |
|
15 |
15 |
$0.00 |
| 99173 |
|
25 |
25 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90680 |
|
249 |
246 |
$0.00 |
| 90723 |
|
94 |
92 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90697 |
|
214 |
208 |
$0.00 |
| 90686 |
|
418 |
403 |
$0.00 |