| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
469 |
449 |
$288.86 |
| 99401 |
|
250 |
249 |
$175.40 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
969 |
856 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
62 |
62 |
$0.00 |
| 99000 |
|
75 |
71 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 94760 |
|
496 |
451 |
$0.00 |
| 92583 |
|
98 |
95 |
$0.00 |
| 90686 |
|
303 |
295 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
211 |
210 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
253 |
252 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
106 |
97 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
232 |
231 |
$0.00 |
| 99173 |
|
609 |
604 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
21 |
$0.00 |