| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,204 |
1,191 |
$32K |
| 90651 |
|
208 |
167 |
$5K |
| 0001A |
|
79 |
76 |
$4K |
| 0012A |
|
139 |
133 |
$4K |
| 0064A |
|
33 |
32 |
$3K |
| 0011A |
|
156 |
149 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
93 |
72 |
$2K |
| 0071A |
|
15 |
15 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
109 |
90 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
110 |
90 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
114 |
97 |
$1K |
| 0002A |
|
36 |
36 |
$1K |
| 0134A |
|
12 |
12 |
$956.28 |
| 90734 |
|
526 |
482 |
$728.44 |
| 90686 |
|
55 |
51 |
$638.86 |
| 90715 |
|
233 |
210 |
$480.33 |
| 36416 |
|
152 |
145 |
$469.11 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
21 |
17 |
$441.67 |
| H1010 |
Non-medical family planning education, per session |
17 |
17 |
$411.40 |
| 90656 |
|
80 |
78 |
$276.12 |
| 90620 |
|
57 |
46 |
$179.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
22 |
12 |
$161.03 |
| 83655 |
|
50 |
44 |
$138.47 |
| 90461 |
|
209 |
89 |
$55.00 |
| 91301 |
|
301 |
284 |
$0.44 |
| 91300 |
|
148 |
123 |
$0.41 |
| 91306 |
|
32 |
31 |
$0.10 |
| 91307 |
|
22 |
17 |
$0.04 |
| 99000 |
|
152 |
145 |
$0.00 |
| 90633 |
|
55 |
42 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |