| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,853 |
5,724 |
$237K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,177 |
1,049 |
$55K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,009 |
967 |
$48K |
| 90651 |
|
1,151 |
1,103 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,083 |
936 |
$21K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,035 |
932 |
$17K |
| S4993 |
Contraceptive pills for birth control |
220 |
196 |
$16K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
164 |
150 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
83 |
74 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
406 |
366 |
$9K |
| 90734 |
|
1,017 |
958 |
$8K |
| 81025 |
|
998 |
924 |
$8K |
| 90715 |
|
1,072 |
1,028 |
$7K |
| 99402 |
|
122 |
108 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47 |
44 |
$5K |
| 90710 |
|
537 |
512 |
$5K |
| 90480 |
|
111 |
99 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54 |
54 |
$4K |
| 90688 |
|
300 |
299 |
$4K |
| 90670 |
|
574 |
547 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
29 |
$3K |
| A4267 |
Contraceptive supply, condom, male, each |
3,940 |
3,424 |
$2K |
| 90686 |
|
1,426 |
1,369 |
$2K |
| 91322 |
|
38 |
32 |
$1K |
| 99000 |
|
505 |
482 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
503 |
458 |
$1K |
| 90677 |
|
200 |
179 |
$1K |
| 90656 |
|
172 |
159 |
$927.72 |
| 90633 |
|
899 |
862 |
$838.80 |
| 0072A |
|
14 |
14 |
$784.88 |
| 83655 |
|
82 |
60 |
$778.28 |
| 90620 |
|
17 |
14 |
$584.30 |
| 0071A |
|
15 |
14 |
$574.00 |
| 99459 |
|
37 |
28 |
$567.50 |
| 90473 |
|
24 |
24 |
$464.76 |
| 91321 |
|
23 |
21 |
$352.95 |
| 90696 |
|
181 |
179 |
$340.54 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
44 |
40 |
$234.66 |
| 36416 |
|
60 |
60 |
$190.62 |
| 86580 |
|
32 |
25 |
$179.83 |
| 90707 |
|
12 |
12 |
$164.98 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
13 |
$147.41 |
| 90723 |
|
281 |
272 |
$134.90 |
| 90716 |
|
13 |
12 |
$129.30 |
| 90647 |
|
28 |
26 |
$88.89 |
| 90648 |
|
437 |
423 |
$78.82 |
| 86592 |
|
512 |
468 |
$3.84 |
| 99072 |
|
274 |
249 |
$0.00 |
| 90681 |
|
15 |
12 |
$0.00 |
| 90685 |
|
15 |
15 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
14 |
12 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 90700 |
|
24 |
24 |
$0.00 |
| 87390 |
|
446 |
409 |
$0.00 |
| 99070 |
|
78 |
61 |
$0.00 |
| 87110 |
|
1,833 |
1,541 |
$0.00 |
| 86803 |
|
37 |
33 |
$0.00 |
| 90697 |
|
34 |
29 |
$0.00 |
| 91307 |
|
41 |
34 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
93 |
69 |
$0.00 |