| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,758 |
1,667 |
$70K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
432 |
383 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
359 |
350 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,337 |
1,246 |
$13K |
| 99402 |
|
229 |
210 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
337 |
300 |
$5K |
| 90651 |
|
161 |
147 |
$4K |
| 83655 |
|
293 |
252 |
$3K |
| 81025 |
|
564 |
493 |
$3K |
| 99401 |
|
80 |
65 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
42 |
$2K |
| 85018 |
|
642 |
579 |
$2K |
| 36416 |
|
652 |
587 |
$1K |
| 92551 |
|
169 |
148 |
$1K |
| 99381 |
|
13 |
13 |
$1K |
| 90686 |
|
360 |
349 |
$615.00 |
| D1206 |
Topical application of fluoride varnish |
84 |
84 |
$574.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
54 |
53 |
$560.00 |
| 90715 |
|
255 |
245 |
$550.69 |
| 99173 |
|
194 |
170 |
$528.28 |
| 96127 |
|
107 |
90 |
$397.21 |
| D0190 |
|
84 |
84 |
$336.00 |
| 36415 |
Collection of venous blood by venipuncture |
119 |
111 |
$231.03 |
| 90461 |
|
837 |
800 |
$135.12 |
| 90716 |
|
60 |
56 |
$115.17 |
| 90734 |
|
69 |
64 |
$107.91 |
| 90688 |
|
75 |
73 |
$90.00 |
| 90707 |
|
49 |
45 |
$64.03 |
| 90633 |
|
99 |
90 |
$29.63 |
| 90670 |
|
72 |
71 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90677 |
|
13 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90647 |
|
16 |
16 |
$0.00 |