| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0012A |
|
667 |
660 |
$25K |
| 0011A |
|
747 |
739 |
$23K |
| 0071A |
|
252 |
242 |
$20K |
| 0072A |
|
151 |
144 |
$12K |
| 0002A |
|
154 |
152 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
353 |
338 |
$9K |
| 0001A |
|
133 |
132 |
$8K |
| 0064A |
|
98 |
94 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
291 |
276 |
$6K |
| 0004A |
|
76 |
76 |
$6K |
| 90686 |
|
189 |
174 |
$2K |
| 90480 |
|
80 |
78 |
$2K |
| 0031A |
|
44 |
44 |
$2K |
| 91322 |
|
12 |
12 |
$2K |
| 0111A |
|
16 |
16 |
$1K |
| 91320 |
|
13 |
13 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
24 |
$986.75 |
| 90656 |
|
13 |
13 |
$255.26 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$26.94 |
| 91301 |
|
823 |
790 |
$1.90 |
| 91307 |
|
321 |
293 |
$0.96 |
| A4215 |
Needle, sterile, any size, each |
14 |
14 |
$0.65 |
| 91300 |
|
258 |
245 |
$0.46 |
| 91306 |
|
52 |
52 |
$0.22 |
| 91311 |
|
32 |
31 |
$0.02 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
38 |
36 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |