| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,917 |
2,756 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
690 |
690 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
718 |
717 |
$17K |
| 92552 |
|
2,151 |
2,148 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
768 |
768 |
$16K |
| 85018 |
|
1,558 |
1,550 |
$4K |
| 99173 |
|
1,737 |
1,733 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,872 |
2,620 |
$3K |
| 81007 |
|
225 |
224 |
$863.54 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$723.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$413.34 |
| 81000 |
|
145 |
145 |
$400.44 |
| 90700 |
|
242 |
242 |
$270.00 |
| 90648 |
|
127 |
127 |
$207.00 |
| 90670 |
|
90 |
90 |
$171.00 |
| 90686 |
|
431 |
431 |
$126.45 |
| 96156 |
|
1,006 |
1,006 |
$109.00 |
| 90713 |
|
98 |
98 |
$90.00 |
| 83655 |
|
13 |
13 |
$55.26 |
| 90461 |
|
444 |
415 |
$17.70 |
| 81002 |
|
92 |
89 |
$8.46 |
| 90688 |
|
36 |
36 |
$0.00 |
| 96151 |
|
39 |
39 |
$0.00 |