| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
243 |
224 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
289 |
273 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
88 |
87 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
462 |
452 |
$2K |
| 90686 |
|
82 |
80 |
$363.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
453 |
387 |
$272.55 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
208 |
208 |
$175.33 |
| 90685 |
|
47 |
45 |
$159.72 |
| 90670 |
|
54 |
54 |
$0.00 |
| 99177 |
|
89 |
89 |
$0.00 |
| 90680 |
|
25 |
25 |
$0.00 |
| 90698 |
|
55 |
55 |
$0.00 |
| 90474 |
|
25 |
25 |
$0.00 |