| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,763 |
1,654 |
$70K |
| 99401 |
|
990 |
886 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
216 |
189 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
225 |
208 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,197 |
1,092 |
$10K |
| 99381 |
|
120 |
108 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
490 |
445 |
$7K |
| 81025 |
|
1,071 |
955 |
$5K |
| 83655 |
|
423 |
360 |
$4K |
| 92551 |
|
320 |
276 |
$2K |
| 0001A |
|
54 |
51 |
$2K |
| 85018 |
|
714 |
621 |
$2K |
| 99383 |
|
14 |
12 |
$1K |
| 90715 |
|
436 |
420 |
$1K |
| 0002A |
|
30 |
27 |
$1K |
| 36416 |
|
716 |
622 |
$1K |
| 99173 |
|
321 |
276 |
$821.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
68 |
$681.21 |
| 99402 |
|
15 |
14 |
$639.68 |
| 96127 |
|
164 |
144 |
$611.13 |
| 90651 |
|
207 |
201 |
$554.55 |
| D1206 |
Topical application of fluoride varnish |
109 |
109 |
$553.50 |
| 90734 |
|
212 |
204 |
$450.40 |
| 90686 |
|
383 |
368 |
$375.00 |
| D0190 |
|
110 |
110 |
$336.00 |
| 99177 |
|
42 |
42 |
$318.27 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$290.62 |
| 36415 |
Collection of venous blood by venipuncture |
113 |
99 |
$192.48 |
| 90707 |
|
88 |
75 |
$75.30 |
| 90716 |
|
108 |
89 |
$65.33 |
| 90461 |
|
784 |
735 |
$45.04 |
| 90696 |
|
27 |
19 |
$0.00 |
| 90619 |
|
55 |
51 |
$0.00 |
| 90688 |
|
38 |
35 |
$0.00 |
| 91300 |
|
21 |
21 |
$0.00 |