| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
48 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
62 |
58 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
42 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$803.87 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
47 |
44 |
$251.70 |
| 1111F |
|
92 |
83 |
$0.00 |
| 90698 |
|
15 |
14 |
$0.00 |
| 3008F |
|
58 |
54 |
$0.00 |