| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,674 |
4,907 |
$34K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,111 |
2,511 |
$29K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,373 |
1,143 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
898 |
713 |
$9K |
| 90686 |
|
2,587 |
2,273 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
632 |
511 |
$6K |
| 90651 |
|
525 |
455 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
131 |
88 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
245 |
195 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
140 |
124 |
$4K |
| 87210 |
|
508 |
441 |
$1K |
| 90715 |
|
446 |
384 |
$1K |
| 86580 |
|
101 |
69 |
$813.13 |
| 81025 |
|
262 |
201 |
$790.61 |
| 0001A |
|
31 |
22 |
$760.44 |
| 0002A |
|
31 |
18 |
$600.00 |
| 90662 |
|
172 |
152 |
$315.36 |
| 90734 |
|
333 |
272 |
$232.60 |
| 85018 |
|
56 |
52 |
$84.66 |
| S4993 |
Contraceptive pills for birth control |
12 |
12 |
$42.95 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
72 |
57 |
$24.93 |
| 90656 |
|
297 |
217 |
$0.00 |
| 90619 |
|
218 |
203 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
240 |
229 |
$0.00 |
| 90620 |
|
18 |
18 |
$0.00 |
| 90696 |
|
83 |
74 |
$0.00 |
| 0064A |
|
14 |
12 |
$0.00 |
| 87806 |
|
493 |
431 |
$0.00 |
| 90710 |
|
131 |
113 |
$0.00 |
| 90633 |
|
37 |
35 |
$0.00 |
| 91300 |
|
58 |
42 |
$0.00 |
| 90621 |
|
13 |
12 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
14 |
12 |
$0.00 |