| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
408 |
388 |
$7K |
| 99188 |
|
417 |
410 |
$6K |
| D1206 |
Topical application of fluoride varnish |
287 |
281 |
$3K |
| 92587 |
|
70 |
67 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
44 |
44 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 92567 |
|
70 |
67 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
16 |
$472.50 |
| 90686 |
|
249 |
238 |
$297.18 |
| 90688 |
|
61 |
60 |
$249.76 |
| 83655 |
|
35 |
34 |
$199.05 |
| 99173 |
|
17 |
17 |
$85.00 |
| 96127 |
|
15 |
15 |
$46.35 |
| 85018 |
|
35 |
34 |
$38.29 |
| G0008 |
Administration of influenza virus vaccine |
199 |
199 |
$0.00 |
| 0012A |
|
52 |
52 |
$0.00 |
| 0011A |
|
53 |
53 |
$0.00 |
| 0064A |
|
56 |
56 |
$0.00 |
| 90662 |
|
110 |
110 |
$0.00 |