| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
867 |
845 |
$34K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
171 |
168 |
$8K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
170 |
167 |
$8K |
| 0001A |
|
102 |
95 |
$4K |
| 90632 |
|
58 |
58 |
$3K |
| 0012A |
|
142 |
133 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
62 |
57 |
$3K |
| 0002A |
|
86 |
81 |
$3K |
| 0011A |
|
139 |
133 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
99 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
62 |
52 |
$2K |
| 90461 |
|
27 |
26 |
$2K |
| 0064A |
|
85 |
61 |
$920.00 |
| 90686 |
|
100 |
96 |
$760.87 |
| 90633 |
|
410 |
406 |
$577.00 |
| 90651 |
|
114 |
114 |
$488.20 |
| 90734 |
|
133 |
132 |
$483.60 |
| 0031A |
|
24 |
19 |
$416.78 |
| 99442 |
|
23 |
22 |
$406.69 |
| 99443 |
|
13 |
13 |
$318.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
14 |
$249.92 |
| 90715 |
|
31 |
31 |
$176.04 |
| 90656 |
|
12 |
12 |
$155.10 |
| 81002 |
|
66 |
65 |
$34.50 |
| 81025 |
|
12 |
12 |
$19.10 |
| 91301 |
|
161 |
141 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
23 |
18 |
$0.00 |
| 91303 |
|
22 |
18 |
$0.00 |