| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,524 |
2,422 |
$108K |
| 90461 |
|
1,415 |
1,356 |
$93K |
| 90632 |
|
153 |
144 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
371 |
349 |
$8K |
| 90633 |
|
955 |
933 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
150 |
138 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
97 |
92 |
$5K |
| 90686 |
|
608 |
573 |
$4K |
| 90670 |
|
686 |
665 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
72 |
71 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
72 |
71 |
$4K |
| D1206 |
Topical application of fluoride varnish |
134 |
133 |
$2K |
| 90734 |
|
263 |
258 |
$2K |
| 90619 |
|
29 |
27 |
$2K |
| 90688 |
|
118 |
117 |
$1K |
| 90651 |
|
203 |
197 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$1K |
| 99201 |
|
24 |
24 |
$920.76 |
| 90715 |
|
157 |
150 |
$857.52 |
| 90698 |
|
145 |
144 |
$736.00 |
| 90685 |
|
126 |
116 |
$699.20 |
| 90636 |
|
13 |
13 |
$461.50 |
| 90682 |
|
28 |
24 |
$425.71 |
| 90744 |
|
28 |
28 |
$239.20 |
| 90723 |
|
50 |
47 |
$220.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$200.32 |
| 90696 |
|
17 |
16 |
$128.80 |
| 90716 |
|
12 |
12 |
$110.40 |
| 90710 |
|
15 |
14 |
$73.60 |
| 81025 |
|
12 |
12 |
$20.91 |
| 90680 |
|
48 |
45 |
$18.40 |
| G0008 |
Administration of influenza virus vaccine |
78 |
71 |
$0.00 |
| 90647 |
|
34 |
31 |
$0.00 |
| 90687 |
|
18 |
16 |
$0.00 |
| 90707 |
|
13 |
12 |
$0.00 |