| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
79 |
79 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
42 |
$2K |
| 92587 |
|
30 |
30 |
$671.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
27 |
$390.32 |
| 82820 |
|
29 |
29 |
$131.04 |
| 81002 |
|
16 |
16 |
$20.00 |
| 99172 |
|
13 |
13 |
$0.00 |
| 99000 |
|
13 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$0.00 |