| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,083 |
1,032 |
$44K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
517 |
431 |
$41K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,433 |
1,122 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
358 |
338 |
$34K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,338 |
1,315 |
$30K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
223 |
218 |
$21K |
| 87538 |
|
596 |
587 |
$18K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
640 |
629 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
113 |
112 |
$14K |
| 90739 |
|
80 |
79 |
$14K |
| S4993 |
Contraceptive pills for birth control |
147 |
142 |
$13K |
| 90632 |
|
152 |
147 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
208 |
188 |
$12K |
| 86780 |
|
702 |
684 |
$10K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
286 |
274 |
$10K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
273 |
262 |
$10K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
272 |
261 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
50 |
49 |
$9K |
| 90715 |
|
444 |
442 |
$6K |
| 90716 |
|
194 |
194 |
$5K |
| 90713 |
|
293 |
289 |
$5K |
| 81025 |
|
440 |
423 |
$4K |
| 90651 |
|
240 |
239 |
$4K |
| 90707 |
|
121 |
120 |
$3K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
35 |
28 |
$3K |
| 90480 |
|
82 |
82 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
232 |
228 |
$2K |
| 80305 |
|
211 |
95 |
$2K |
| 86803 |
|
134 |
131 |
$2K |
| 90656 |
|
100 |
98 |
$2K |
| 81001 |
|
488 |
480 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
19 |
19 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
148 |
140 |
$673.44 |
| 86593 |
|
131 |
127 |
$661.12 |
| 90473 |
|
29 |
29 |
$594.30 |
| 88142 |
|
21 |
20 |
$483.76 |
| Q3014 |
Telehealth originating site facility fee |
19 |
15 |
$467.82 |
| 87562 |
|
12 |
12 |
$297.74 |
| 87210 |
|
48 |
47 |
$151.11 |
| 80053 |
Comprehensive metabolic panel |
12 |
12 |
$138.11 |
| 81002 |
|
27 |
26 |
$45.56 |
| 87535 |
|
262 |
259 |
$42.11 |
| 90619 |
|
336 |
335 |
$0.05 |
| 90633 |
|
276 |
274 |
$0.04 |
| 90744 |
|
74 |
74 |
$0.00 |
| 90696 |
|
107 |
107 |
$0.00 |
| 90697 |
|
47 |
47 |
$0.00 |
| 90680 |
|
29 |
29 |
$0.00 |
| 90677 |
|
139 |
139 |
$0.00 |
| 90698 |
|
17 |
15 |
$0.00 |
| 90700 |
|
53 |
53 |
$0.00 |
| 90710 |
|
186 |
183 |
$0.00 |
| 90734 |
|
29 |
29 |
$0.00 |