| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,952 |
2,729 |
$124K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
517 |
506 |
$33K |
| D1206 |
Topical application of fluoride varnish |
1,244 |
1,241 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
288 |
278 |
$21K |
| 99381 |
|
208 |
203 |
$16K |
| 99401 |
|
566 |
491 |
$15K |
| D0190 |
|
1,235 |
1,233 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,455 |
1,394 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
504 |
437 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
184 |
173 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
153 |
137 |
$5K |
| 90651 |
|
409 |
365 |
$5K |
| 81025 |
|
947 |
804 |
$4K |
| 92551 |
|
525 |
458 |
$4K |
| 0001A |
|
81 |
63 |
$3K |
| 96127 |
|
640 |
561 |
$2K |
| 90715 |
|
741 |
684 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,057 |
909 |
$2K |
| 99173 |
|
447 |
381 |
$1K |
| 90716 |
|
210 |
204 |
$1K |
| 0002A |
|
37 |
31 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
43 |
40 |
$1K |
| 90707 |
|
225 |
216 |
$1K |
| 90734 |
|
277 |
261 |
$971.19 |
| 99177 |
|
86 |
82 |
$731.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
50 |
$456.43 |
| 90619 |
|
67 |
55 |
$388.29 |
| 90713 |
|
148 |
144 |
$305.27 |
| 90688 |
|
203 |
180 |
$205.00 |
| 90461 |
|
1,244 |
1,158 |
$135.12 |
| 85018 |
|
35 |
27 |
$64.04 |
| 90633 |
|
249 |
241 |
$59.26 |
| 90656 |
|
13 |
13 |
$50.00 |
| 90696 |
|
110 |
103 |
$47.17 |
| 36416 |
|
36 |
30 |
$44.43 |
| 90686 |
|
37 |
34 |
$30.00 |
| 90648 |
|
65 |
64 |
$0.00 |
| 90700 |
|
57 |
57 |
$0.00 |
| 90710 |
|
185 |
172 |
$0.00 |
| 90670 |
|
69 |
68 |
$0.00 |
| 91300 |
|
19 |
18 |
$0.00 |
| 90744 |
|
15 |
14 |
$0.00 |