| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
654 |
635 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
938 |
917 |
$31K |
| 90632 |
|
422 |
417 |
$25K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
925 |
904 |
$20K |
| 90461 |
|
293 |
287 |
$11K |
| 0001A |
|
254 |
249 |
$9K |
| 0002A |
|
250 |
241 |
$9K |
| 83655 |
|
431 |
422 |
$7K |
| 0031A |
|
229 |
222 |
$6K |
| 0012A |
|
258 |
244 |
$5K |
| 0011A |
|
301 |
265 |
$5K |
| 99401 |
|
156 |
151 |
$5K |
| D1206 |
Topical application of fluoride varnish |
217 |
214 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
86 |
$4K |
| 0071A |
|
74 |
74 |
$3K |
| 0064A |
|
126 |
105 |
$3K |
| 0072A |
|
60 |
60 |
$2K |
| 90651 |
|
72 |
71 |
$2K |
| 90734 |
|
115 |
113 |
$2K |
| 97802 |
|
13 |
13 |
$2K |
| 0004A |
|
57 |
51 |
$1K |
| 90633 |
|
410 |
402 |
$1K |
| 90688 |
|
75 |
74 |
$1K |
| 0034A |
|
47 |
38 |
$800.00 |
| 90686 |
|
353 |
350 |
$738.02 |
| 0134A |
|
15 |
14 |
$400.00 |
| 0003A |
|
48 |
47 |
$400.00 |
| 90620 |
|
15 |
15 |
$368.85 |
| 0054A |
|
41 |
40 |
$320.00 |
| 90715 |
|
56 |
50 |
$254.12 |
| 92551 |
|
17 |
17 |
$177.82 |
| 0124A |
|
36 |
36 |
$160.00 |
| 99173 |
|
16 |
16 |
$40.32 |
| 90710 |
|
16 |
16 |
$36.80 |
| 91301 |
|
263 |
237 |
$0.01 |
| 91303 |
|
52 |
52 |
$0.00 |