| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,343 |
1,248 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
76 |
70 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
381 |
342 |
$4K |
| 99401 |
|
139 |
128 |
$4K |
| D1206 |
Topical application of fluoride varnish |
160 |
152 |
$3K |
| D0190 |
|
159 |
151 |
$2K |
| 81025 |
|
206 |
178 |
$1K |
| 90688 |
|
589 |
550 |
$995.00 |
| 90651 |
|
42 |
37 |
$924.25 |
| 92551 |
|
115 |
96 |
$797.20 |
| 90715 |
|
165 |
154 |
$775.50 |
| 96127 |
|
159 |
138 |
$740.86 |
| 0001A |
|
18 |
16 |
$600.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
57 |
49 |
$436.62 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
24 |
24 |
$382.66 |
| 99173 |
|
89 |
75 |
$239.50 |
| 90734 |
|
41 |
35 |
$215.82 |
| 36416 |
|
80 |
72 |
$134.00 |
| 85018 |
|
52 |
44 |
$112.06 |
| 90707 |
|
42 |
37 |
$64.03 |
| 90461 |
|
369 |
338 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90686 |
|
84 |
82 |
$0.00 |
| 90716 |
|
39 |
34 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |