| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21,328 |
17,177 |
$940K |
| 99401 |
|
15,013 |
12,491 |
$393K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,836 |
5,089 |
$267K |
| 99402 |
|
3,448 |
2,937 |
$149K |
| 90473 |
|
6,673 |
6,380 |
$102K |
| 90651 |
|
4,156 |
3,631 |
$93K |
| 90697 |
|
1,234 |
986 |
$67K |
| 90677 |
|
893 |
741 |
$63K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,503 |
4,392 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,646 |
1,451 |
$53K |
| 81025 |
|
8,992 |
7,740 |
$47K |
| 90715 |
|
5,037 |
4,350 |
$37K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
438 |
356 |
$35K |
| 90734 |
|
3,083 |
2,643 |
$33K |
| 90632 |
|
664 |
512 |
$30K |
| 90716 |
|
3,091 |
2,756 |
$22K |
| 90686 |
|
3,690 |
3,178 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
645 |
541 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,079 |
863 |
$17K |
| 90670 |
|
4,651 |
4,029 |
$17K |
| 36415 |
Collection of venous blood by venipuncture |
9,256 |
7,818 |
$15K |
| 90707 |
|
3,037 |
2,684 |
$15K |
| 87808 |
|
3,201 |
2,622 |
$14K |
| 90461 |
|
13,944 |
12,004 |
$13K |
| 90619 |
|
478 |
415 |
$11K |
| 90672 |
|
7,860 |
7,218 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
199 |
187 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,021 |
763 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
746 |
664 |
$8K |
| 90710 |
|
1,503 |
1,331 |
$6K |
| 87210 |
|
1,910 |
1,564 |
$6K |
| 99403 |
|
80 |
70 |
$5K |
| 90746 |
|
98 |
74 |
$4K |
| 90674 |
|
400 |
353 |
$3K |
| 90633 |
|
4,712 |
4,119 |
$3K |
| 90723 |
|
2,670 |
2,385 |
$2K |
| 90656 |
|
205 |
166 |
$2K |
| 90691 |
|
46 |
38 |
$2K |
| 90696 |
|
1,723 |
1,547 |
$2K |
| 99384 |
|
17 |
16 |
$2K |
| 90680 |
|
2,420 |
2,065 |
$2K |
| 91322 |
|
16 |
12 |
$1K |
| 99385 |
|
16 |
14 |
$1K |
| 90688 |
|
140 |
91 |
$1K |
| 90713 |
|
655 |
591 |
$1K |
| 90647 |
|
3,488 |
3,116 |
$991.56 |
| 90717 |
|
18 |
16 |
$984.62 |
| 90700 |
|
2,290 |
2,037 |
$947.11 |
| 90682 |
|
28 |
25 |
$877.10 |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$818.67 |
| 99201 |
|
34 |
26 |
$812.26 |
| 90480 |
|
21 |
17 |
$718.68 |
| 99173 |
|
74 |
60 |
$595.98 |
| 90621 |
|
45 |
40 |
$556.75 |
| 99442 |
|
27 |
21 |
$515.57 |
| 90662 |
|
67 |
33 |
$450.00 |
| 88738 |
|
78 |
68 |
$444.87 |
| 99441 |
|
42 |
33 |
$437.02 |
| 90714 |
|
21 |
15 |
$436.83 |
| 96127 |
|
100 |
85 |
$384.56 |
| 92551 |
|
54 |
48 |
$374.50 |
| 85018 |
|
87 |
60 |
$275.33 |
| 86580 |
|
18 |
16 |
$129.21 |
| 90744 |
|
121 |
99 |
$73.85 |
| G0008 |
Administration of influenza virus vaccine |
18 |
13 |
$26.14 |
| 90661 |
|
18 |
18 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
103 |
72 |
$0.00 |
| 99000 |
|
2,916 |
2,370 |
$0.00 |