| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
235 |
235 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
169 |
169 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
108 |
108 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
62 |
62 |
$3K |
| 92551 |
|
238 |
238 |
$2K |
| 85018 |
|
363 |
363 |
$731.44 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$180.00 |
| 83655 |
|
34 |
34 |
$145.52 |
| 92081 |
|
65 |
65 |
$60.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
308 |
308 |
$13.26 |
| 90744 |
|
45 |
45 |
$0.00 |
| 90688 |
|
57 |
57 |
$0.00 |
| 90698 |
|
72 |
72 |
$0.00 |
| 90686 |
|
35 |
35 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90670 |
|
110 |
109 |
$0.00 |
| 90633 |
|
68 |
68 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
161 |
159 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |