| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13,045 |
12,967 |
$225K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18,263 |
18,134 |
$181K |
| 36416 |
|
20,105 |
16,684 |
$136K |
| 99172 |
|
12,278 |
12,173 |
$113K |
| V5008 |
Hearing screening |
10,118 |
10,009 |
$93K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,465 |
2,728 |
$64K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,452 |
2,727 |
$64K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,305 |
4,147 |
$57K |
| 90716 |
|
1,723 |
1,720 |
$55K |
| 90651 |
|
3,503 |
3,490 |
$42K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
2,681 |
2,635 |
$40K |
| 83655 |
|
3,217 |
3,094 |
$38K |
| 85018 |
|
17,380 |
16,786 |
$37K |
| 90715 |
|
4,185 |
4,176 |
$32K |
| 90746 |
|
599 |
596 |
$31K |
| 90707 |
|
1,540 |
1,537 |
$27K |
| 90632 |
|
1,040 |
1,035 |
$26K |
| 91322 |
|
179 |
179 |
$20K |
| 90688 |
|
934 |
934 |
$15K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,423 |
1,404 |
$15K |
| 86580 |
|
2,056 |
2,039 |
$11K |
| 90480 |
|
349 |
349 |
$9K |
| 90620 |
|
498 |
495 |
$9K |
| 81025 |
|
1,347 |
1,286 |
$8K |
| 90732 |
|
76 |
76 |
$7K |
| 90474 |
|
957 |
957 |
$4K |
| 90734 |
|
2,649 |
2,641 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
71 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
38 |
$3K |
| 90670 |
|
3,182 |
3,173 |
$3K |
| 86592 |
|
1,134 |
1,124 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
32 |
$2K |
| 90682 |
|
51 |
51 |
$2K |
| 90677 |
|
228 |
227 |
$1K |
| 90658 |
|
85 |
85 |
$1K |
| 90619 |
|
1,210 |
1,210 |
$1K |
| 90713 |
|
321 |
321 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
105 |
104 |
$849.39 |
| A4267 |
Contraceptive supply, condom, male, each |
1,956 |
1,902 |
$524.64 |
| 90686 |
|
2,158 |
2,157 |
$213.25 |
| 0011A |
|
14 |
14 |
$211.93 |
| 90656 |
|
67 |
67 |
$80.00 |
| 87210 |
|
14 |
12 |
$48.20 |
| 90696 |
|
1,558 |
1,556 |
$0.00 |
| 90698 |
|
1,744 |
1,741 |
$0.00 |
| 90647 |
|
666 |
663 |
$0.00 |
| 90680 |
|
945 |
942 |
$0.00 |
| 90744 |
|
1,088 |
1,086 |
$0.00 |
| 90723 |
|
622 |
618 |
$0.00 |
| 99000 |
|
43 |
43 |
$0.00 |
| 90697 |
|
299 |
299 |
$0.00 |
| 91301 |
|
13 |
13 |
$0.00 |
| 87520 |
|
488 |
482 |
$0.00 |
| 90700 |
|
1,287 |
1,284 |
$0.00 |
| 90633 |
|
3,893 |
3,881 |
$0.00 |
| 90710 |
|
2,474 |
2,470 |
$0.00 |
| 90685 |
|
403 |
401 |
$0.00 |
| 90671 |
|
72 |
72 |
$0.00 |
| 90648 |
|
32 |
31 |
$0.00 |
| 91300 |
|
14 |
14 |
$0.00 |
| 90621 |
|
17 |
17 |
$0.00 |
| 91321 |
|
12 |
12 |
$0.00 |