| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,153 |
9,938 |
$158K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
6,252 |
6,133 |
$130K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,359 |
3,085 |
$74K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,356 |
3,085 |
$66K |
| 90651 |
|
1,976 |
1,936 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
647 |
610 |
$52K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
690 |
657 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,015 |
859 |
$15K |
| 90716 |
|
1,390 |
1,360 |
$15K |
| 86703 |
|
2,150 |
2,038 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
357 |
337 |
$12K |
| 90715 |
|
1,566 |
1,535 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
67 |
63 |
$7K |
| 90686 |
|
4,114 |
4,039 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
212 |
205 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
61 |
59 |
$5K |
| 90707 |
|
1,219 |
1,187 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
77 |
74 |
$4K |
| 86592 |
|
2,060 |
1,970 |
$4K |
| S4993 |
Contraceptive pills for birth control |
396 |
372 |
$4K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
665 |
636 |
$3K |
| 90480 |
|
133 |
128 |
$3K |
| 90636 |
|
35 |
34 |
$2K |
| 90734 |
|
1,613 |
1,591 |
$2K |
| 90474 |
|
185 |
183 |
$2K |
| 87806 |
|
127 |
121 |
$2K |
| 81025 |
|
369 |
354 |
$1K |
| 91322 |
|
39 |
39 |
$1K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,677 |
1,362 |
$963.55 |
| 87210 |
|
798 |
733 |
$962.74 |
| 0124A |
|
28 |
27 |
$962.65 |
| 90620 |
|
192 |
191 |
$795.45 |
| 90732 |
|
18 |
18 |
$728.83 |
| 0051A |
|
17 |
17 |
$663.32 |
| 90670 |
|
1,376 |
1,359 |
$629.14 |
| 0072A |
|
13 |
13 |
$547.69 |
| 90656 |
|
101 |
101 |
$425.27 |
| 0121A |
|
12 |
12 |
$412.73 |
| 90710 |
|
708 |
703 |
$146.37 |
| 90648 |
|
700 |
694 |
$56.97 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
18 |
13 |
$38.88 |
| 86593 |
|
12 |
12 |
$23.22 |
| 90700 |
|
293 |
289 |
$22.96 |
| 90744 |
|
24 |
24 |
$20.21 |
| 90713 |
|
223 |
222 |
$17.92 |
| 90696 |
|
608 |
593 |
$0.00 |
| 91305 |
|
67 |
63 |
$0.00 |
| 90677 |
|
46 |
46 |
$0.00 |
| 90698 |
|
169 |
168 |
$0.00 |
| 90723 |
|
769 |
762 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
15 |
12 |
$0.00 |
| 91319 |
|
20 |
20 |
$0.00 |
| 91307 |
|
22 |
18 |
$0.00 |
| 90633 |
|
1,546 |
1,526 |
$0.00 |
| 90681 |
|
197 |
195 |
$0.00 |
| 90685 |
|
94 |
94 |
$0.00 |
| 91312 |
|
43 |
41 |
$0.00 |
| 91300 |
|
49 |
42 |
$0.00 |
| 91321 |
|
12 |
12 |
$0.00 |