| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,129 |
1,064 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
478 |
458 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
258 |
237 |
$7K |
| 0002A |
|
103 |
98 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
268 |
218 |
$4K |
| 0001A |
|
90 |
81 |
$3K |
| 0012A |
|
52 |
32 |
$1K |
| 90682 |
|
24 |
21 |
$998.07 |
| 90686 |
|
155 |
146 |
$922.97 |
| 0011A |
|
83 |
49 |
$710.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
42 |
38 |
$559.89 |
| 90673 |
|
38 |
20 |
$557.82 |
| 86580 |
|
170 |
149 |
$433.57 |
| 90734 |
|
129 |
121 |
$220.62 |
| 90651 |
|
51 |
50 |
$191.27 |
| 91301 |
|
102 |
92 |
$90.06 |
| 0064A |
|
17 |
16 |
$80.00 |
| 90620 |
|
35 |
33 |
$37.19 |
| 90619 |
|
26 |
25 |
$0.19 |
| 90715 |
|
31 |
30 |
$0.00 |
| 91306 |
|
14 |
14 |
$0.00 |