| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99051 |
|
18,626 |
16,533 |
$285K |
| 99429 |
|
18,556 |
16,470 |
$150K |
| 90670 |
|
1,044 |
635 |
$75K |
| 90649 |
|
1,269 |
767 |
$72K |
| 90733 |
|
863 |
552 |
$42K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,737 |
2,257 |
$27K |
| 90621 |
|
549 |
360 |
$25K |
| 0004A |
|
648 |
647 |
$24K |
| 0012A |
|
1,077 |
782 |
$23K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,246 |
1,309 |
$20K |
| 0072A |
|
498 |
495 |
$19K |
| 0001A |
|
478 |
455 |
$17K |
| 0064A |
|
471 |
461 |
$16K |
| 0011A |
|
858 |
780 |
$16K |
| 0002A |
|
392 |
387 |
$15K |
| 0013A |
|
343 |
342 |
$13K |
| 90697 |
|
469 |
241 |
$11K |
| 0003A |
|
258 |
258 |
$10K |
| 90707 |
|
835 |
529 |
$10K |
| 90716 |
|
662 |
432 |
$9K |
| 90715 |
|
816 |
508 |
$9K |
| 0071A |
|
265 |
263 |
$9K |
| 90633 |
|
796 |
490 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,965 |
1,998 |
$5K |
| 0054A |
|
176 |
166 |
$5K |
| 90686 |
|
788 |
505 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
121 |
108 |
$5K |
| 90461 |
|
1,726 |
1,172 |
$3K |
| 0124A |
|
71 |
45 |
$2K |
| 0134A |
|
58 |
33 |
$2K |
| 90677 |
|
416 |
246 |
$1K |
| 90647 |
|
126 |
92 |
$1K |
| 90700 |
|
210 |
140 |
$752.30 |
| 90696 |
|
153 |
121 |
$684.00 |
| 90698 |
|
275 |
193 |
$628.53 |
| 0031A |
|
95 |
95 |
$560.00 |
| 90734 |
|
440 |
260 |
$484.47 |
| 90681 |
|
555 |
307 |
$451.86 |
| 0074A |
|
12 |
12 |
$440.00 |
| 90651 |
|
439 |
260 |
$326.20 |
| 90620 |
|
65 |
43 |
$0.06 |
| 90623 |
|
85 |
53 |
$0.00 |
| 90648 |
|
19 |
12 |
$0.00 |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
105 |
105 |
$0.00 |
| 91307 |
|
327 |
317 |
$0.00 |
| 90680 |
|
47 |
30 |
$0.00 |
| 90744 |
|
47 |
35 |
$0.00 |