| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21,931 |
18,237 |
$512K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30,174 |
25,232 |
$332K |
| 90716 |
|
5,328 |
4,651 |
$219K |
| 90651 |
|
8,316 |
7,271 |
$194K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,914 |
2,567 |
$191K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,804 |
2,531 |
$172K |
| 90715 |
|
7,760 |
6,804 |
$61K |
| 83655 |
|
7,753 |
6,222 |
$57K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,914 |
1,724 |
$56K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,914 |
1,723 |
$56K |
| 86703 |
|
3,380 |
3,078 |
$35K |
| 90713 |
|
3,951 |
3,598 |
$32K |
| 90707 |
|
1,392 |
1,188 |
$30K |
| 90739 |
|
323 |
312 |
$30K |
| 90620 |
|
2,948 |
2,454 |
$20K |
| 81025 |
|
2,858 |
2,561 |
$19K |
| 90686 |
|
5,973 |
5,010 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
211 |
194 |
$18K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
529 |
454 |
$15K |
| 36415 |
Collection of venous blood by venipuncture |
4,020 |
3,439 |
$14K |
| 86580 |
|
3,319 |
2,412 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
159 |
148 |
$13K |
| 81000 |
|
3,561 |
3,093 |
$11K |
| 90746 |
|
434 |
368 |
$11K |
| 90734 |
|
5,628 |
4,814 |
$8K |
| 90674 |
|
1,289 |
1,236 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
32 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
31 |
$4K |
| 90480 |
|
752 |
662 |
$4K |
| 99383 |
|
40 |
39 |
$4K |
| T1029 |
Comprehensive environmental lead investigation, not including laboratory analysis, per dwelling |
34 |
24 |
$4K |
| 86480 |
|
2,615 |
2,405 |
$3K |
| 36416 |
|
1,701 |
1,229 |
$3K |
| 99382 |
|
29 |
28 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
70 |
62 |
$3K |
| 99173 |
|
1,387 |
1,277 |
$2K |
| 90661 |
|
854 |
683 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
142 |
128 |
$2K |
| 90670 |
|
2,573 |
2,185 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
78 |
70 |
$1K |
| 96150 |
|
127 |
112 |
$1K |
| 87210 |
|
284 |
264 |
$877.57 |
| 92551 |
|
117 |
107 |
$832.00 |
| 90677 |
|
139 |
117 |
$780.00 |
| 90710 |
|
2,654 |
2,351 |
$640.12 |
| 81003 |
|
269 |
247 |
$485.38 |
| 90619 |
|
1,762 |
1,526 |
$435.00 |
| 87428 |
|
13 |
12 |
$424.00 |
| 90473 |
|
29 |
26 |
$403.98 |
| 90694 |
|
17 |
17 |
$300.00 |
| 90632 |
|
18 |
15 |
$270.00 |
| 86592 |
|
39 |
31 |
$125.46 |
| D1206 |
Topical application of fluoride varnish |
26 |
25 |
$89.00 |
| 90682 |
|
3,156 |
2,701 |
$80.01 |
| 90633 |
|
7,816 |
6,938 |
$75.33 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$71.00 |
| 90744 |
|
1,477 |
1,352 |
$50.04 |
| 90656 |
|
68 |
52 |
$39.86 |
| 90696 |
|
754 |
665 |
$7.76 |
| 90698 |
|
238 |
189 |
$0.03 |
| 90700 |
|
1,039 |
882 |
$0.02 |
| 90647 |
|
847 |
666 |
$0.01 |
| 90685 |
|
32 |
26 |
$0.01 |
| 90697 |
|
115 |
106 |
$0.00 |
| 90723 |
|
656 |
507 |
$0.00 |
| 86481 |
|
14 |
13 |
$0.00 |
| 86682 |
|
1,300 |
1,042 |
$0.00 |
| 90671 |
|
146 |
135 |
$0.00 |
| 91322 |
|
674 |
621 |
$0.00 |
| 91321 |
|
545 |
468 |
$0.00 |
| 91300 |
|
12 |
12 |
$0.00 |
| D1120 |
Prophylaxis - child |
12 |
12 |
$0.00 |
| 90672 |
|
48 |
42 |
$0.00 |