| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,990 |
3,931 |
$104K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,291 |
6,195 |
$88K |
| T1001 |
Nursing assessment / evaluation |
624 |
595 |
$14K |
| 90474 |
|
461 |
449 |
$6K |
| 81025 |
|
1,057 |
927 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115 |
108 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
225 |
184 |
$4K |
| 90686 |
|
1,681 |
1,612 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
236 |
204 |
$3K |
| 90651 |
|
574 |
566 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
59 |
59 |
$2K |
| 81002 |
|
664 |
597 |
$2K |
| 90688 |
|
218 |
160 |
$1K |
| 90716 |
|
137 |
130 |
$915.13 |
| 90473 |
|
55 |
54 |
$781.23 |
| 90715 |
|
379 |
376 |
$290.73 |
| 90670 |
|
1,463 |
1,438 |
$230.14 |
| 92587 |
|
13 |
12 |
$220.00 |
| 90707 |
|
86 |
83 |
$210.54 |
| 90620 |
|
174 |
172 |
$165.75 |
| 90656 |
|
93 |
92 |
$126.36 |
| 99173 |
|
27 |
27 |
$125.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$105.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
185 |
154 |
$82.49 |
| 85018 |
|
27 |
25 |
$28.84 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
119 |
110 |
$4.85 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
186 |
155 |
$0.05 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
30 |
25 |
$0.05 |
| 86592 |
|
30 |
25 |
$0.02 |
| 90713 |
|
16 |
12 |
$0.00 |
| 90633 |
|
838 |
830 |
$0.00 |
| 90710 |
|
291 |
289 |
$0.00 |
| 90734 |
|
548 |
541 |
$0.00 |
| 83655 |
|
40 |
39 |
$0.00 |
| 90700 |
|
108 |
104 |
$0.00 |
| 90685 |
|
212 |
207 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |
| 90681 |
|
14 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
366 |
331 |
$0.00 |
| 90697 |
|
190 |
190 |
$0.00 |
| 90680 |
|
510 |
496 |
$0.00 |
| 90723 |
|
965 |
944 |
$0.00 |
| 90647 |
|
948 |
929 |
$0.00 |
| 90677 |
|
136 |
135 |
$0.00 |
| 90696 |
|
196 |
193 |
$0.00 |
| 90619 |
|
294 |
292 |
$0.00 |
| 97802 |
|
30 |
30 |
$0.00 |