| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90632 |
|
508 |
488 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
677 |
637 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
766 |
757 |
$23K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
722 |
690 |
$16K |
| 0012A |
|
346 |
341 |
$10K |
| 0011A |
|
342 |
335 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
121 |
117 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
384 |
343 |
$7K |
| 0002A |
|
118 |
116 |
$4K |
| 0001A |
|
113 |
111 |
$4K |
| 86580 |
|
498 |
443 |
$3K |
| D1206 |
Topical application of fluoride varnish |
164 |
148 |
$3K |
| 0064A |
|
53 |
49 |
$2K |
| 0031A |
|
49 |
47 |
$2K |
| 90461 |
|
28 |
28 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
17 |
$1K |
| 0072A |
|
17 |
17 |
$680.00 |
| 90688 |
|
48 |
44 |
$621.76 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
12 |
$605.75 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
16 |
12 |
$605.75 |
| 0004A |
|
27 |
27 |
$560.00 |
| 90633 |
|
487 |
482 |
$431.20 |
| 92551 |
|
38 |
38 |
$397.48 |
| 90619 |
|
30 |
30 |
$246.00 |
| 90734 |
|
117 |
117 |
$147.10 |
| 99173 |
|
40 |
40 |
$75.60 |
| 91301 |
|
186 |
174 |
$0.01 |