| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
358 |
358 |
$19K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
111 |
110 |
$10K |
| 99402 |
|
73 |
72 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
60 |
$3K |
| 99442 |
|
91 |
89 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
120 |
119 |
$2K |
| 92551 |
|
47 |
47 |
$352.62 |
| 81025 |
|
44 |
42 |
$220.83 |
| 83655 |
|
15 |
15 |
$192.38 |
| 99173 |
|
28 |
28 |
$187.34 |
| 96127 |
|
42 |
42 |
$168.48 |
| 36415 |
Collection of venous blood by venipuncture |
77 |
75 |
$149.40 |
| 85018 |
|
13 |
13 |
$33.37 |
| 36416 |
|
15 |
15 |
$23.45 |
| 90686 |
|
95 |
95 |
$0.00 |
| 90696 |
|
32 |
32 |
$0.00 |
| 90698 |
|
47 |
47 |
$0.00 |
| 90651 |
|
115 |
115 |
$0.00 |
| 90672 |
|
13 |
13 |
$0.00 |
| 90710 |
|
34 |
34 |
$0.00 |
| 90734 |
|
120 |
120 |
$0.00 |
| 90715 |
|
104 |
104 |
$0.00 |
| 90633 |
|
18 |
18 |
$0.00 |
| 90670 |
|
59 |
59 |
$0.00 |