| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management, each 15 minutes |
1,333 |
1,040 |
$561K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,064 |
1,902 |
$255K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
728 |
714 |
$7K |
| 90686 |
|
401 |
380 |
$5K |
| 90651 |
|
74 |
69 |
$4K |
| 0012A |
|
174 |
137 |
$3K |
| 91320 |
|
56 |
56 |
$2K |
| 90480 |
|
92 |
92 |
$2K |
| S4993 |
Contraceptive pills for birth control |
209 |
183 |
$2K |
| 0011A |
|
181 |
144 |
$2K |
| 81025 |
|
316 |
287 |
$2K |
| 0124A |
|
42 |
38 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
196 |
192 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
140 |
139 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
549 |
520 |
$1K |
| 0064A |
|
38 |
34 |
$920.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
161 |
157 |
$576.93 |
| 91322 |
|
18 |
18 |
$573.89 |
| 90715 |
|
26 |
25 |
$564.53 |
| 86703 |
|
106 |
76 |
$551.14 |
| 0002A |
|
43 |
31 |
$539.41 |
| 86780 |
|
121 |
90 |
$528.88 |
| 90619 |
|
13 |
13 |
$404.52 |
| 90685 |
|
26 |
26 |
$403.68 |
| 91319 |
|
15 |
15 |
$338.29 |
| 0001A |
|
37 |
28 |
$324.18 |
| 90633 |
|
16 |
16 |
$307.44 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
19 |
19 |
$230.35 |
| 96160 |
|
71 |
71 |
$145.27 |
| 86803 |
|
13 |
13 |
$81.65 |
| 36415 |
Collection of venous blood by venipuncture |
49 |
34 |
$4.20 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$0.00 |
| 91306 |
|
27 |
27 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
140 |
139 |
$0.00 |
| 91307 |
|
15 |
15 |
$0.00 |
| 91312 |
|
33 |
32 |
$0.00 |