| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,743 |
4,460 |
$35K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,362 |
2,661 |
$30K |
| 90649 |
|
1,366 |
1,127 |
$15K |
| 90620 |
|
397 |
307 |
$13K |
| 0001A |
|
479 |
434 |
$11K |
| 0003A |
|
240 |
234 |
$9K |
| 90734 |
|
851 |
679 |
$8K |
| 0002A |
|
265 |
243 |
$7K |
| 0071A |
|
68 |
67 |
$2K |
| 0012A |
|
76 |
64 |
$2K |
| 0072A |
|
43 |
43 |
$2K |
| 0011A |
|
78 |
65 |
$1K |
| 90696 |
|
93 |
79 |
$1K |
| 90715 |
|
402 |
347 |
$997.79 |
| 0031A |
|
24 |
24 |
$960.00 |
| 90658 |
|
900 |
642 |
$905.20 |
| 90670 |
|
1,047 |
896 |
$443.49 |
| 90633 |
|
487 |
410 |
$430.00 |
| 90707 |
|
442 |
391 |
$372.00 |
| 90716 |
|
489 |
436 |
$362.00 |
| 90698 |
|
200 |
183 |
$340.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
15 |
15 |
$314.02 |
| 80061 |
Lipid panel |
17 |
17 |
$286.08 |
| 90700 |
|
300 |
248 |
$240.00 |
| 80053 |
Comprehensive metabolic panel |
14 |
14 |
$197.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
19 |
$197.22 |
| 90647 |
|
119 |
96 |
$134.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
12 |
12 |
$129.60 |
| 90680 |
|
148 |
134 |
$106.00 |
| 81000 |
|
15 |
15 |
$59.22 |
| 90723 |
|
51 |
49 |
$48.00 |
| 90744 |
|
40 |
38 |
$12.00 |
| 90713 |
|
58 |
58 |
$0.00 |
| 90621 |
|
72 |
72 |
$0.00 |
| 90648 |
|
30 |
28 |
$0.00 |