| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,746 |
1,724 |
$79K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
856 |
712 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,284 |
1,264 |
$24K |
| 90686 |
|
766 |
763 |
$2K |
| 90474 |
|
62 |
62 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
34 |
33 |
$1K |
| 90670 |
|
694 |
683 |
$986.14 |
| T1001 |
Nursing assessment / evaluation |
37 |
37 |
$885.00 |
| 97802 |
|
33 |
33 |
$657.20 |
| 0072A |
|
16 |
16 |
$640.00 |
| 0002A |
|
15 |
15 |
$600.00 |
| 0001A |
|
14 |
14 |
$560.00 |
| 90620 |
|
26 |
26 |
$498.93 |
| 0071A |
|
12 |
12 |
$480.00 |
| 92582 |
|
18 |
18 |
$344.48 |
| 92567 |
|
14 |
14 |
$209.04 |
| 90651 |
|
126 |
125 |
$206.96 |
| 99173 |
|
33 |
33 |
$155.00 |
| 90715 |
|
116 |
116 |
$42.14 |
| 90677 |
|
15 |
15 |
$0.03 |
| 90734 |
|
68 |
68 |
$0.01 |
| 90648 |
|
28 |
28 |
$0.00 |
| 0004A |
|
23 |
23 |
$0.00 |
| 90662 |
|
32 |
32 |
$0.00 |
| 90633 |
|
137 |
134 |
$0.00 |
| 90710 |
|
95 |
94 |
$0.00 |
| 91300 |
|
67 |
59 |
$0.00 |
| 90461 |
|
14 |
14 |
$0.00 |
| 83655 |
|
17 |
16 |
$0.00 |
| 90619 |
|
128 |
128 |
$0.00 |
| 90680 |
|
128 |
128 |
$0.00 |
| 90696 |
|
28 |
28 |
$0.00 |
| 90697 |
|
105 |
104 |
$0.00 |
| 90698 |
|
300 |
296 |
$0.00 |
| 90723 |
|
25 |
25 |
$0.00 |
| 85018 |
|
17 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
46 |
46 |
$0.00 |
| 90744 |
|
38 |
38 |
$0.00 |
| 91307 |
|
39 |
37 |
$0.00 |