| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90461 |
|
631 |
622 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
935 |
913 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
390 |
359 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
668 |
643 |
$15K |
| 99201 |
|
196 |
185 |
$10K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
294 |
283 |
$9K |
| 86480 |
|
194 |
188 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
59 |
58 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42 |
40 |
$4K |
| 86580 |
|
473 |
455 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
142 |
140 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
111 |
95 |
$2K |
| 90686 |
|
182 |
172 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
68 |
$2K |
| 81025 |
|
246 |
223 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
861 |
827 |
$711.00 |
| 90707 |
|
13 |
13 |
$650.28 |
| 87210 |
|
244 |
229 |
$477.12 |
| 90688 |
|
23 |
23 |
$437.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$344.52 |
| 80076 |
|
31 |
29 |
$187.89 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
201 |
192 |
$169.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
29 |
28 |
$1.52 |
| 90739 |
|
16 |
15 |
$0.00 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
12 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
67 |
57 |
$0.00 |