| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
106,025 |
46,552 |
$1.57M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
9,758 |
8,729 |
$135K |
| 90651 |
|
7,487 |
7,073 |
$72K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,159 |
4,214 |
$65K |
| 90686 |
|
8,498 |
7,760 |
$48K |
| 90480 |
|
1,349 |
1,117 |
$44K |
| 90632 |
|
857 |
764 |
$40K |
| 91320 |
|
510 |
397 |
$38K |
| 91322 |
|
417 |
336 |
$38K |
| 90716 |
|
3,234 |
3,050 |
$34K |
| 90715 |
|
8,280 |
7,848 |
$34K |
| 0001A |
|
738 |
724 |
$30K |
| 90707 |
|
2,962 |
2,812 |
$26K |
| 0002A |
|
698 |
692 |
$22K |
| 86580 |
|
3,904 |
3,207 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
506 |
441 |
$19K |
| 0071A |
|
188 |
183 |
$16K |
| 0064A |
|
274 |
263 |
$16K |
| 90636 |
|
227 |
205 |
$15K |
| 0072A |
|
151 |
150 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,421 |
889 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
248 |
213 |
$11K |
| 90688 |
|
1,619 |
1,488 |
$11K |
| 0004A |
|
179 |
176 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
182 |
159 |
$10K |
| 0011A |
|
457 |
440 |
$10K |
| 90746 |
|
177 |
157 |
$10K |
| 0012A |
|
344 |
338 |
$9K |
| 90670 |
|
6,168 |
5,797 |
$8K |
| 90619 |
|
3,956 |
3,816 |
$8K |
| 0124A |
|
208 |
208 |
$8K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
184 |
167 |
$8K |
| 90734 |
|
8,485 |
8,066 |
$8K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
241 |
224 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
616 |
466 |
$6K |
| 90677 |
|
1,054 |
992 |
$6K |
| 90620 |
|
727 |
705 |
$6K |
| 90682 |
|
94 |
86 |
$4K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
443 |
398 |
$4K |
| 90656 |
|
519 |
516 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
449 |
401 |
$4K |
| 0013A |
|
37 |
36 |
$3K |
| 0003A |
|
94 |
93 |
$3K |
| 0031A |
|
32 |
32 |
$3K |
| 0134A |
|
90 |
85 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47 |
38 |
$3K |
| 90673 |
|
35 |
35 |
$2K |
| 90674 |
|
167 |
153 |
$2K |
| 90474 |
|
260 |
256 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
949 |
856 |
$2K |
| 90662 |
|
47 |
38 |
$2K |
| 99385 |
|
26 |
23 |
$2K |
| 90739 |
|
12 |
12 |
$2K |
| 90710 |
|
2,562 |
2,450 |
$1K |
| 0052A |
|
12 |
12 |
$1K |
| 0081A |
|
14 |
14 |
$1K |
| 81025 |
|
200 |
173 |
$955.34 |
| 71045 |
Radiologic examination, chest; single view |
72 |
71 |
$820.48 |
| 90661 |
|
49 |
49 |
$750.45 |
| 90671 |
|
449 |
425 |
$748.30 |
| 99401 |
|
36 |
35 |
$681.46 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
28 |
26 |
$500.08 |
| 90658 |
|
78 |
75 |
$451.53 |
| 90633 |
|
7,847 |
7,430 |
$441.11 |
| 81002 |
|
182 |
159 |
$391.74 |
| 83655 |
|
72 |
63 |
$321.95 |
| 71046 |
Radiologic examination, chest; 2 views |
14 |
13 |
$316.77 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
18 |
14 |
$307.20 |
| 99201 |
|
17 |
13 |
$306.15 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$240.57 |
| 36416 |
|
72 |
62 |
$145.20 |
| 91319 |
|
36 |
33 |
$132.42 |
| 90648 |
|
2,010 |
1,913 |
$119.73 |
| 90713 |
|
1,259 |
1,189 |
$103.55 |
| 90672 |
|
29 |
27 |
$75.02 |
| 87210 |
|
16 |
14 |
$61.18 |
| 82120 |
|
16 |
14 |
$53.88 |
| 83986 |
|
16 |
14 |
$32.28 |
| 90700 |
|
1,360 |
1,316 |
$29.95 |
| 90696 |
|
1,803 |
1,729 |
$26.14 |
| 90744 |
|
2,633 |
2,442 |
$25.12 |
| 85018 |
|
15 |
14 |
$22.32 |
| 91300 |
|
2,362 |
2,192 |
$18.11 |
| 91301 |
|
1,021 |
985 |
$7.55 |
| 90698 |
|
3,500 |
3,227 |
$6.88 |
| 90680 |
|
1,486 |
1,375 |
$4.63 |
| 91307 |
|
448 |
408 |
$3.81 |
| 90723 |
|
868 |
831 |
$3.00 |
| 91312 |
|
214 |
213 |
$1.56 |
| 91306 |
|
180 |
177 |
$1.14 |
| 91313 |
|
93 |
87 |
$0.61 |
| 91305 |
|
49 |
46 |
$0.32 |
| 91303 |
|
32 |
32 |
$0.28 |
| 90685 |
|
354 |
309 |
$0.26 |
| 90681 |
|
271 |
258 |
$0.24 |
| 90697 |
|
1,486 |
1,412 |
$0.23 |
| 90649 |
|
63 |
63 |
$0.22 |
| 91321 |
|
41 |
41 |
$0.21 |
| 91308 |
|
26 |
26 |
$0.17 |
| 91315 |
|
14 |
13 |
$0.14 |
| 90621 |
|
151 |
134 |
$0.07 |
| 90647 |
|
17 |
15 |
$0.02 |
| 90461 |
|
74 |
57 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
18 |
15 |
$0.00 |
| 86593 |
|
16 |
15 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
16 |
15 |
$0.00 |