| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,972 |
1,892 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,435 |
1,280 |
$51K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,761 |
1,582 |
$26K |
| D1206 |
Topical application of fluoride varnish |
1,508 |
1,488 |
$24K |
| 99401 |
|
788 |
686 |
$21K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
256 |
223 |
$17K |
| D0190 |
|
1,203 |
1,185 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
346 |
310 |
$9K |
| 81025 |
|
1,538 |
1,330 |
$7K |
| D1120 |
Prophylaxis - child |
195 |
195 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
190 |
188 |
$4K |
| 0001A |
|
116 |
95 |
$4K |
| 87210 |
|
954 |
834 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,327 |
1,195 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
51 |
$3K |
| 0002A |
|
43 |
32 |
$1K |
| 0011A |
|
40 |
36 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
14 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
139 |
131 |
$777.20 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
12 |
$687.58 |
| 90651 |
|
71 |
71 |
$547.40 |
| 90734 |
|
32 |
29 |
$431.64 |
| 90686 |
|
495 |
483 |
$405.00 |
| 90619 |
|
59 |
57 |
$258.86 |
| 90716 |
|
39 |
38 |
$180.50 |
| 90715 |
|
83 |
83 |
$146.52 |
| 90461 |
|
912 |
873 |
$135.12 |
| 90707 |
|
49 |
48 |
$64.03 |
| 90633 |
|
101 |
99 |
$47.15 |
| 90656 |
|
28 |
28 |
$47.06 |
| 85018 |
|
15 |
12 |
$23.25 |
| 90688 |
|
39 |
39 |
$0.00 |
| 90677 |
|
46 |
43 |
$0.00 |
| 90696 |
|
25 |
24 |
$0.00 |
| 90674 |
|
123 |
122 |
$0.00 |
| 36416 |
|
15 |
12 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 91301 |
|
15 |
15 |
$0.00 |
| 90710 |
|
29 |
28 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 90671 |
|
13 |
13 |
$0.00 |
| 91300 |
|
23 |
21 |
$0.00 |
| 90658 |
|
61 |
59 |
$0.00 |