| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
264 |
264 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
27 |
$421.68 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$50.07 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$46.96 |
| 99173 |
|
19 |
19 |
$0.00 |
| 3008F |
|
149 |
149 |
$0.00 |
| 90686 |
|
43 |
43 |
$0.00 |
| 1126F |
|
186 |
181 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |