| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
993 |
921 |
$44K |
| D1206 |
Topical application of fluoride varnish |
2,273 |
2,225 |
$37K |
| D0190 |
|
2,273 |
2,225 |
$22K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
592 |
508 |
$9K |
| 99402 |
|
108 |
96 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
58 |
57 |
$4K |
| 99401 |
|
96 |
73 |
$2K |
| 0001A |
|
63 |
52 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
262 |
247 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
26 |
$1K |
| 90651 |
|
69 |
56 |
$1K |
| 81025 |
|
199 |
160 |
$995.03 |
| 90619 |
|
39 |
29 |
$906.01 |
| 0002A |
|
25 |
20 |
$748.88 |
| 90686 |
|
154 |
126 |
$345.00 |
| 36415 |
Collection of venous blood by venipuncture |
131 |
119 |
$290.27 |
| 90715 |
|
165 |
156 |
$225.66 |
| 90734 |
|
61 |
57 |
$215.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
24 |
$168.17 |
| 90716 |
|
29 |
28 |
$115.17 |
| 85018 |
|
41 |
40 |
$62.00 |
| 90461 |
|
530 |
498 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| 90710 |
|
28 |
25 |
$0.00 |
| 90707 |
|
16 |
15 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 36416 |
|
41 |
40 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |