| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,703 |
2,591 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
954 |
886 |
$69K |
| 99401 |
|
2,217 |
1,971 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
833 |
785 |
$52K |
| 99381 |
|
317 |
296 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,478 |
2,315 |
$24K |
| 83655 |
|
1,092 |
988 |
$12K |
| D1206 |
Topical application of fluoride varnish |
863 |
861 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
760 |
701 |
$11K |
| 81025 |
|
1,673 |
1,474 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
290 |
250 |
$7K |
| D0190 |
|
826 |
824 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
52 |
$5K |
| 92551 |
|
590 |
537 |
$4K |
| 85018 |
|
1,003 |
865 |
$2K |
| 36416 |
|
1,326 |
1,165 |
$2K |
| 90651 |
|
249 |
234 |
$2K |
| 96127 |
|
414 |
373 |
$2K |
| 99383 |
|
15 |
13 |
$1K |
| 99173 |
|
395 |
367 |
$1K |
| 90715 |
|
399 |
387 |
$921.26 |
| 36415 |
Collection of venous blood by venipuncture |
503 |
446 |
$873.32 |
| 99177 |
|
114 |
91 |
$683.69 |
| 0001A |
|
25 |
22 |
$643.32 |
| 90716 |
|
177 |
153 |
$575.85 |
| 90734 |
|
197 |
185 |
$539.55 |
| 90686 |
|
1,122 |
1,101 |
$535.00 |
| 0002A |
|
15 |
15 |
$400.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
15 |
12 |
$357.38 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
37 |
$337.27 |
| 90707 |
|
168 |
144 |
$293.77 |
| 90619 |
|
85 |
82 |
$258.86 |
| 90688 |
|
29 |
29 |
$175.00 |
| 90633 |
|
139 |
123 |
$59.26 |
| 90656 |
|
15 |
15 |
$48.74 |
| 90696 |
|
79 |
76 |
$47.17 |
| 90461 |
|
1,016 |
961 |
$0.00 |
| 90710 |
|
26 |
26 |
$0.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$0.00 |
| 90670 |
|
41 |
40 |
$0.00 |
| 90723 |
|
26 |
25 |
$0.00 |
| 90647 |
|
44 |
43 |
$0.00 |
| D1330 |
|
17 |
16 |
$0.00 |
| 99000 |
|
18 |
17 |
$0.00 |