| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,993 |
6,271 |
$110K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,509 |
2,231 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
329 |
276 |
$19K |
| 90686 |
|
1,946 |
1,842 |
$17K |
| 90651 |
|
425 |
408 |
$16K |
| 90682 |
|
547 |
487 |
$13K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
318 |
300 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
532 |
496 |
$7K |
| 90715 |
|
731 |
673 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
404 |
352 |
$6K |
| 90670 |
|
431 |
403 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$5K |
| 90480 |
|
329 |
286 |
$4K |
| 90734 |
|
192 |
178 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
30 |
26 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
14 |
$2K |
| 90710 |
|
99 |
82 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$1K |
| 91320 |
|
111 |
100 |
$833.15 |
| 90707 |
|
26 |
25 |
$617.62 |
| 90473 |
|
25 |
25 |
$450.47 |
| 90685 |
|
139 |
138 |
$446.25 |
| 87210 |
|
118 |
100 |
$369.10 |
| 90619 |
|
36 |
34 |
$345.00 |
| 36415 |
Collection of venous blood by venipuncture |
114 |
88 |
$333.12 |
| 91322 |
|
37 |
36 |
$291.84 |
| 81025 |
|
59 |
53 |
$283.70 |
| 90680 |
|
24 |
24 |
$200.29 |
| 90633 |
|
98 |
96 |
$189.07 |
| 90723 |
|
54 |
54 |
$182.23 |
| 90696 |
|
60 |
42 |
$120.00 |
| 90647 |
|
65 |
65 |
$93.99 |
| 91319 |
|
14 |
13 |
$80.15 |
| 86580 |
|
12 |
12 |
$61.38 |
| 90697 |
|
52 |
52 |
$0.00 |
| 90656 |
|
46 |
42 |
$0.00 |