| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 97803 |
|
4,158 |
4,150 |
$126K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,262 |
5,204 |
$103K |
| D1206 |
Topical application of fluoride varnish |
2,776 |
2,757 |
$65K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,121 |
5,698 |
$18K |
| 99173 |
|
3,405 |
3,401 |
$12K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
387 |
385 |
$10K |
| G9920 |
Screening performed and negative |
271 |
270 |
$9K |
| 97802 |
|
218 |
215 |
$7K |
| 99188 |
|
274 |
274 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,816 |
1,809 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,679 |
1,660 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
641 |
640 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,046 |
1,044 |
$807.69 |
| 83655 |
|
62 |
62 |
$740.08 |
| 92552 |
|
3,377 |
3,372 |
$95.14 |
| 90670 |
|
1,309 |
1,308 |
$54.54 |
| 90658 |
|
1,302 |
1,301 |
$45.71 |
| 90723 |
|
929 |
927 |
$45.54 |
| 90680 |
|
308 |
307 |
$27.00 |
| 90633 |
|
639 |
636 |
$18.27 |
| 90648 |
|
1,269 |
1,268 |
$18.00 |
| 90655 |
|
165 |
165 |
$9.00 |
| 90710 |
|
678 |
671 |
$9.00 |
| 90734 |
|
365 |
365 |
$0.00 |
| 90649 |
|
462 |
462 |
$0.00 |
| 90715 |
|
77 |
77 |
$0.00 |
| 90700 |
|
27 |
27 |
$0.00 |
| 99382 |
|
13 |
13 |
$0.00 |
| 90696 |
|
158 |
152 |
$0.00 |