| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,371 |
2,218 |
$106K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
765 |
694 |
$11K |
| D1206 |
Topical application of fluoride varnish |
458 |
455 |
$9K |
| D0190 |
|
458 |
455 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
134 |
119 |
$5K |
| 99401 |
|
129 |
119 |
$4K |
| 0001A |
|
111 |
86 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
140 |
123 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
41 |
$3K |
| 90651 |
|
341 |
309 |
$2K |
| 0002A |
|
38 |
28 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
196 |
172 |
$1K |
| 81025 |
|
169 |
155 |
$742.47 |
| 0011A |
|
23 |
20 |
$683.32 |
| 0012A |
|
18 |
14 |
$563.32 |
| 36415 |
Collection of venous blood by venipuncture |
301 |
262 |
$471.12 |
| 90734 |
|
125 |
120 |
$431.64 |
| 90710 |
|
109 |
106 |
$238.04 |
| 90677 |
|
145 |
139 |
$235.22 |
| 90715 |
|
323 |
296 |
$150.44 |
| 90619 |
|
206 |
180 |
$129.43 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
13 |
$116.11 |
| 90461 |
|
1,720 |
1,607 |
$90.08 |
| 85018 |
|
36 |
31 |
$55.80 |
| 87210 |
|
18 |
14 |
$52.70 |
| 90696 |
|
53 |
51 |
$47.17 |
| 36416 |
|
69 |
64 |
$21.13 |
| 90686 |
|
139 |
130 |
$15.00 |
| 90647 |
|
37 |
33 |
$0.00 |
| 90697 |
|
301 |
279 |
$0.00 |
| 90674 |
|
30 |
30 |
$0.00 |
| 90716 |
|
68 |
63 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90670 |
|
249 |
233 |
$0.00 |
| 90700 |
|
46 |
39 |
$0.00 |
| 90633 |
|
288 |
263 |
$0.00 |
| 90671 |
|
166 |
158 |
$0.00 |
| 90658 |
|
21 |
21 |
$0.00 |
| 90707 |
|
66 |
61 |
$0.00 |
| 91300 |
|
17 |
17 |
$0.00 |