| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,943 |
872 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
884 |
761 |
$47K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
321 |
279 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
148 |
118 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,560 |
1,193 |
$10K |
| 99401 |
|
282 |
256 |
$4K |
| 96160 |
|
1,579 |
1,313 |
$3K |
| 88738 |
|
395 |
328 |
$1K |
| 96161 |
|
468 |
382 |
$869.82 |
| 3008F |
|
771 |
650 |
$560.00 |
| 99174 |
|
13 |
12 |
$229.03 |
| 90461 |
|
108 |
77 |
$45.04 |
| 90672 |
|
61 |
52 |
$26.88 |
| 90671 |
|
13 |
12 |
$0.13 |
| 90674 |
|
70 |
58 |
$0.00 |
| 1005F |
|
13 |
12 |
$0.00 |
| 90686 |
|
24 |
24 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |
| 99000 |
|
16 |
16 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |
| 90670 |
|
27 |
26 |
$0.00 |
| 90687 |
|
14 |
13 |
$0.00 |