| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,965 |
9,772 |
$192K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,313 |
2,283 |
$81K |
| D1206 |
Topical application of fluoride varnish |
3,139 |
3,089 |
$74K |
| 99381 |
|
671 |
664 |
$47K |
| 99188 |
|
2,131 |
2,115 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,997 |
6,517 |
$42K |
| 99173 |
|
4,195 |
4,160 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,819 |
2,775 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,373 |
2,335 |
$7K |
| 90698 |
|
3,120 |
3,061 |
$5K |
| 90680 |
|
1,947 |
1,911 |
$4K |
| 90670 |
|
2,311 |
2,279 |
$3K |
| 86580 |
|
809 |
797 |
$3K |
| 90744 |
|
1,577 |
1,547 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,293 |
1,282 |
$3K |
| 90381 |
|
120 |
120 |
$3K |
| 90677 |
|
596 |
568 |
$2K |
| 91318 |
|
162 |
162 |
$2K |
| 91320 |
|
148 |
148 |
$1K |
| 91319 |
|
153 |
153 |
$1K |
| 92551 |
|
4,224 |
4,187 |
$849.63 |
| 90686 |
|
4,535 |
4,526 |
$743.97 |
| 90633 |
|
1,562 |
1,536 |
$504.81 |
| 90707 |
|
739 |
725 |
$349.42 |
| 90619 |
|
640 |
638 |
$261.00 |
| 90620 |
|
462 |
462 |
$255.30 |
| 90716 |
|
732 |
719 |
$225.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
524 |
520 |
$213.52 |
| 90651 |
|
1,257 |
1,239 |
$135.27 |
| 90710 |
|
650 |
639 |
$126.00 |
| 90696 |
|
657 |
646 |
$126.00 |
| 90734 |
|
339 |
330 |
$54.00 |
| 90715 |
|
543 |
534 |
$45.00 |
| 83655 |
|
839 |
837 |
$0.00 |