| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,869 |
1,755 |
$72K |
| D1206 |
Topical application of fluoride varnish |
1,118 |
1,108 |
$19K |
| 99402 |
|
252 |
226 |
$13K |
| D0190 |
|
1,118 |
1,108 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
698 |
622 |
$10K |
| 99401 |
|
243 |
210 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
131 |
115 |
$5K |
| 90651 |
|
175 |
156 |
$5K |
| 81025 |
|
765 |
688 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
42 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
765 |
681 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
195 |
186 |
$1K |
| 90715 |
|
286 |
266 |
$975.31 |
| 0011A |
|
28 |
20 |
$915.52 |
| 0001A |
|
27 |
22 |
$868.88 |
| 90619 |
|
88 |
78 |
$517.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
46 |
$465.35 |
| 90734 |
|
77 |
75 |
$438.65 |
| 90716 |
|
85 |
82 |
$426.33 |
| 0012A |
|
15 |
12 |
$403.32 |
| 90688 |
|
30 |
27 |
$360.00 |
| 90461 |
|
815 |
772 |
$258.98 |
| 85018 |
|
113 |
109 |
$176.79 |
| 90686 |
|
383 |
369 |
$135.00 |
| 92551 |
|
12 |
12 |
$93.84 |
| 90707 |
|
79 |
79 |
$37.65 |
| 36416 |
|
115 |
110 |
$16.75 |
| 90710 |
|
36 |
36 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90633 |
|
44 |
44 |
$0.00 |
| 90658 |
|
79 |
79 |
$0.00 |
| 90696 |
|
65 |
65 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |