| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
616 |
611 |
$19K |
| 90461 |
|
233 |
233 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59 |
47 |
$4K |
| 90697 |
|
15 |
15 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
152 |
138 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$949.54 |
| 92551 |
|
71 |
66 |
$543.06 |
| 90686 |
|
49 |
49 |
$89.40 |
| 90656 |
|
51 |
51 |
$43.52 |
| 96161 |
|
31 |
28 |
$31.56 |
| 99406 |
|
17 |
16 |
$27.88 |
| 99173 |
|
39 |
34 |
$3.18 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
61 |
58 |
$0.00 |
| 90670 |
|
16 |
16 |
$0.00 |
| 3008F |
|
106 |
99 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
94 |
86 |
$0.00 |