| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,200 |
2,476 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,985 |
1,817 |
$95K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,075 |
951 |
$81K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
844 |
783 |
$57K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,980 |
2,377 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
583 |
535 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
189 |
179 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
177 |
153 |
$12K |
| 96160 |
|
2,097 |
1,840 |
$8K |
| 88738 |
|
1,228 |
1,133 |
$5K |
| 92587 |
|
237 |
216 |
$5K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
602 |
502 |
$4K |
| 92551 |
|
481 |
445 |
$4K |
| 3008F |
|
1,742 |
1,508 |
$4K |
| 99401 |
|
250 |
218 |
$3K |
| 96161 |
|
725 |
665 |
$3K |
| 99177 |
|
460 |
414 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
118 |
115 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
176 |
72 |
$1K |
| 96127 |
|
255 |
192 |
$975.01 |
| 81002 |
|
388 |
355 |
$934.76 |
| 36416 |
|
691 |
582 |
$884.77 |
| 99173 |
|
236 |
224 |
$709.04 |
| 90670 |
|
748 |
669 |
$250.00 |
| 80061 |
Lipid panel |
15 |
12 |
$238.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
18 |
$182.72 |
| 90688 |
|
400 |
359 |
$168.36 |
| 99051 |
|
62 |
54 |
$167.57 |
| 90716 |
|
117 |
100 |
$150.00 |
| 90672 |
|
153 |
134 |
$145.53 |
| 90707 |
|
117 |
100 |
$90.00 |
| 90633 |
|
144 |
115 |
$87.88 |
| 90686 |
|
426 |
386 |
$44.50 |
| 90647 |
|
346 |
327 |
$34.80 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90681 |
|
136 |
131 |
$0.00 |
| D0190 |
|
363 |
334 |
$0.00 |
| 90685 |
|
111 |
109 |
$0.00 |
| 90687 |
|
69 |
68 |
$0.00 |
| 90461 |
|
15 |
12 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
172 |
155 |
$0.00 |
| 1005F |
|
188 |
166 |
$0.00 |
| 99000 |
|
259 |
224 |
$0.00 |
| 90723 |
|
401 |
373 |
$0.00 |
| 90651 |
|
32 |
32 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
157 |
148 |
$0.00 |
| 90696 |
|
16 |
12 |
$0.00 |
| 90674 |
|
19 |
19 |
$0.00 |