| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
45 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
97 |
76 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
217 |
101 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
86 |
86 |
$683.76 |
| 90461 |
|
32 |
31 |
$248.78 |
| 90686 |
|
64 |
63 |
$0.00 |