| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,038 |
4,627 |
$178K |
| 90651 |
|
649 |
626 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
498 |
453 |
$6K |
| 0064A |
|
74 |
57 |
$4K |
| 90686 |
|
535 |
504 |
$4K |
| 90715 |
|
652 |
637 |
$3K |
| 86580 |
|
411 |
305 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
34 |
$2K |
| 0012A |
|
165 |
161 |
$2K |
| 91320 |
|
33 |
21 |
$2K |
| 0011A |
|
237 |
187 |
$2K |
| 0071A |
|
15 |
15 |
$1K |
| 0072A |
|
12 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
13 |
$937.87 |
| 90480 |
|
38 |
26 |
$918.85 |
| 90734 |
|
940 |
922 |
$794.81 |
| 90670 |
|
666 |
633 |
$675.39 |
| 81025 |
|
105 |
90 |
$602.13 |
| 84591 |
|
95 |
68 |
$207.04 |
| 90620 |
|
97 |
96 |
$179.76 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$78.12 |
| 90688 |
|
19 |
17 |
$53.52 |
| 91306 |
|
66 |
57 |
$0.09 |
| 91300 |
|
47 |
44 |
$0.02 |
| 91301 |
|
414 |
360 |
$0.01 |
| 90648 |
|
131 |
127 |
$0.00 |
| 90633 |
|
606 |
585 |
$0.00 |
| 90671 |
|
406 |
380 |
$0.00 |
| 90710 |
|
175 |
171 |
$0.00 |
| 90681 |
|
96 |
77 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90700 |
|
25 |
25 |
$0.00 |
| 91307 |
|
60 |
58 |
$0.00 |
| 90696 |
|
102 |
96 |
$0.00 |
| 90697 |
|
58 |
57 |
$0.00 |
| 90698 |
|
58 |
41 |
$0.00 |
| 90723 |
|
15 |
15 |
$0.00 |