| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,987 |
2,796 |
$93K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,799 |
1,506 |
$80K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,023 |
974 |
$64K |
| 99381 |
|
714 |
649 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,615 |
1,368 |
$50K |
| 99401 |
|
2,116 |
1,471 |
$49K |
| D1206 |
Topical application of fluoride varnish |
1,621 |
1,584 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
346 |
313 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,450 |
2,262 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
243 |
222 |
$17K |
| D0190 |
|
1,568 |
1,531 |
$15K |
| 0001A |
|
227 |
164 |
$6K |
| 81025 |
|
1,424 |
1,064 |
$6K |
| 92551 |
|
724 |
606 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
218 |
181 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
522 |
465 |
$4K |
| 90688 |
|
1,666 |
1,584 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
248 |
224 |
$4K |
| 96127 |
|
781 |
609 |
$3K |
| 0002A |
|
94 |
66 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,463 |
1,257 |
$2K |
| 99173 |
|
592 |
489 |
$2K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
58 |
51 |
$1K |
| 90651 |
|
80 |
70 |
$1K |
| 90715 |
|
195 |
185 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
32 |
26 |
$1K |
| D1120 |
Prophylaxis - child |
27 |
27 |
$887.38 |
| 90670 |
|
55 |
51 |
$803.30 |
| 90686 |
|
139 |
115 |
$690.00 |
| 90734 |
|
62 |
60 |
$647.46 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
50 |
26 |
$578.68 |
| 90716 |
|
86 |
68 |
$507.15 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
16 |
$468.00 |
| 94250 |
|
17 |
12 |
$306.27 |
| 90707 |
|
82 |
66 |
$176.98 |
| 90461 |
|
911 |
854 |
$112.60 |
| 36416 |
|
76 |
57 |
$87.10 |
| 85018 |
|
24 |
24 |
$60.71 |
| 99000 |
|
29 |
23 |
$0.00 |
| 90633 |
|
94 |
88 |
$0.00 |
| 91300 |
|
44 |
31 |
$0.00 |
| 90756 |
|
13 |
13 |
$0.00 |