| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
875 |
848 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
283 |
277 |
$18K |
| D1206 |
Topical application of fluoride varnish |
1,002 |
993 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,012 |
896 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
176 |
170 |
$12K |
| D0190 |
|
1,002 |
993 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
328 |
290 |
$8K |
| 99401 |
|
227 |
201 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
591 |
575 |
$3K |
| 0001A |
|
73 |
56 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
626 |
532 |
$1K |
| 0002A |
|
31 |
22 |
$886.64 |
| 99381 |
|
12 |
12 |
$883.63 |
| 81025 |
|
117 |
104 |
$541.46 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
16 |
$286.34 |
| 90656 |
|
83 |
83 |
$266.60 |
| 90715 |
|
60 |
56 |
$185.24 |
| 85018 |
|
47 |
42 |
$72.85 |
| 90686 |
|
255 |
255 |
$60.00 |
| 90461 |
|
265 |
247 |
$22.52 |
| 36416 |
|
82 |
75 |
$0.00 |
| 90651 |
|
19 |
19 |
$0.00 |
| 90674 |
|
104 |
100 |
$0.00 |
| 91300 |
|
23 |
21 |
$0.00 |
| 90710 |
|
15 |
15 |
$0.00 |
| 90661 |
|
42 |
42 |
$0.00 |
| 90633 |
|
18 |
18 |
$0.00 |
| 90671 |
|
14 |
14 |
$0.00 |