| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
66 |
50 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
66 |
50 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
74 |
57 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
81 |
63 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
74 |
58 |
$611.28 |
| 96161 |
|
14 |
12 |
$26.18 |
| 3078F |
|
45 |
33 |
$0.00 |
| 90670 |
|
30 |
24 |
$0.00 |
| 3074F |
|
52 |
37 |
$0.00 |