| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,235 |
8,091 |
$147K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,891 |
3,842 |
$87K |
| 0002A |
|
1,900 |
1,898 |
$73K |
| 0001A |
|
2,005 |
2,000 |
$65K |
| 90651 |
|
1,389 |
1,377 |
$40K |
| T1017 |
Targeted case management, each 15 minutes |
151 |
97 |
$38K |
| 90715 |
|
1,717 |
1,705 |
$15K |
| 91320 |
|
119 |
119 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
679 |
673 |
$12K |
| 0004A |
|
311 |
310 |
$12K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
778 |
774 |
$11K |
| 90686 |
|
2,532 |
2,526 |
$11K |
| 90620 |
|
552 |
549 |
$11K |
| 90473 |
|
441 |
441 |
$8K |
| 0072A |
|
195 |
195 |
$8K |
| 0012A |
|
289 |
289 |
$7K |
| 0124A |
|
193 |
193 |
$7K |
| 0071A |
|
204 |
204 |
$7K |
| 90480 |
|
207 |
207 |
$7K |
| 0064A |
|
133 |
132 |
$5K |
| 90734 |
|
960 |
952 |
$5K |
| 0011A |
|
335 |
335 |
$5K |
| 0031A |
|
136 |
136 |
$5K |
| 0054A |
|
88 |
88 |
$3K |
| 90688 |
|
184 |
184 |
$3K |
| 90739 |
|
14 |
14 |
$2K |
| 0134A |
|
47 |
47 |
$2K |
| 0003A |
|
42 |
42 |
$2K |
| 90619 |
|
250 |
250 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 90707 |
|
53 |
52 |
$1K |
| 90716 |
|
57 |
55 |
$1K |
| 90656 |
|
148 |
148 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
112 |
110 |
$1K |
| 90636 |
|
12 |
12 |
$1K |
| 90672 |
|
518 |
515 |
$672.35 |
| 90474 |
|
48 |
48 |
$543.60 |
| 90670 |
|
221 |
219 |
$520.11 |
| 36415 |
Collection of venous blood by venipuncture |
39 |
39 |
$135.20 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
946 |
784 |
$81.48 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
946 |
784 |
$81.48 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
891 |
783 |
$51.00 |
| 90633 |
|
305 |
302 |
$25.00 |
| 90710 |
|
160 |
158 |
$0.00 |
| 91300 |
|
4,288 |
3,815 |
$0.00 |
| 86703 |
|
25 |
25 |
$0.00 |
| 91312 |
|
193 |
193 |
$0.00 |
| 91313 |
|
50 |
49 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
13 |
13 |
$0.00 |
| 86780 |
|
51 |
50 |
$0.00 |
| 91306 |
|
132 |
131 |
$0.00 |
| 91301 |
|
694 |
684 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 91305 |
|
155 |
153 |
$0.00 |
| 90723 |
|
98 |
97 |
$0.00 |
| 91307 |
|
459 |
397 |
$0.00 |
| 90696 |
|
116 |
116 |
$0.00 |
| 91303 |
|
149 |
149 |
$0.00 |
| 90647 |
|
100 |
99 |
$0.00 |
| 86803 |
|
12 |
12 |
$0.00 |