| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,559 |
6,433 |
$224K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,918 |
10,626 |
$207K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,688 |
1,642 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
687 |
663 |
$46K |
| 92551 |
|
3,053 |
2,931 |
$40K |
| 83655 |
|
2,703 |
2,540 |
$28K |
| 90474 |
|
802 |
794 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,039 |
928 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
217 |
209 |
$14K |
| 99173 |
|
3,096 |
2,969 |
$14K |
| 0001A |
|
159 |
159 |
$6K |
| 99382 |
|
104 |
99 |
$6K |
| 0002A |
|
150 |
148 |
$6K |
| 90686 |
|
1,908 |
1,878 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
158 |
151 |
$4K |
| 0071A |
|
104 |
101 |
$4K |
| 0072A |
|
84 |
83 |
$3K |
| 90670 |
|
2,654 |
2,592 |
$2K |
| 90688 |
|
640 |
624 |
$2K |
| 90715 |
|
1,069 |
1,039 |
$2K |
| 90673 |
|
75 |
75 |
$2K |
| 90651 |
|
1,193 |
1,186 |
$1K |
| 0064A |
|
134 |
134 |
$1K |
| 90677 |
|
414 |
410 |
$1K |
| 0012A |
|
125 |
124 |
$1K |
| 91322 |
|
52 |
52 |
$1K |
| 96127 |
|
419 |
395 |
$1K |
| 85018 |
|
881 |
808 |
$998.40 |
| 0011A |
|
131 |
130 |
$872.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$840.00 |
| 90682 |
|
62 |
62 |
$787.27 |
| 86580 |
|
130 |
103 |
$769.71 |
| 90620 |
|
388 |
388 |
$497.25 |
| 90480 |
|
74 |
74 |
$269.13 |
| 90734 |
|
973 |
954 |
$243.26 |
| 90656 |
|
183 |
182 |
$233.95 |
| D1208 |
Topical application of fluoride, excluding varnish |
25 |
15 |
$187.00 |
| 90710 |
|
1,847 |
1,804 |
$140.38 |
| 90633 |
|
2,144 |
2,094 |
$37.89 |
| 90647 |
|
1,719 |
1,673 |
$10.00 |
| 90700 |
|
542 |
531 |
$6.00 |
| 90649 |
|
110 |
100 |
$3.00 |
| 90723 |
|
1,605 |
1,562 |
$0.11 |
| 90619 |
|
717 |
714 |
$0.01 |
| 90680 |
|
188 |
181 |
$0.01 |
| 90696 |
|
509 |
502 |
$0.00 |
| 90697 |
|
787 |
777 |
$0.00 |
| 91306 |
|
29 |
29 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
610 |
607 |
$0.00 |
| 91301 |
|
145 |
140 |
$0.00 |
| 91307 |
|
195 |
185 |
$0.00 |
| 90681 |
|
639 |
631 |
$0.00 |
| 90662 |
|
264 |
262 |
$0.00 |
| 0124A |
|
33 |
33 |
$0.00 |
| 91300 |
|
379 |
365 |
$0.00 |
| 0004A |
|
44 |
44 |
$0.00 |
| 90685 |
|
114 |
110 |
$0.00 |
| 91304 |
|
14 |
14 |
$0.00 |
| 0054A |
|
12 |
12 |
$0.00 |