| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
2,966 |
2,863 |
$737K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,204 |
3,148 |
$59K |
| T1017 |
Targeted case management, each 15 minutes |
760 |
716 |
$36K |
| 90686 |
|
1,689 |
1,668 |
$12K |
| 91322 |
|
21 |
21 |
$2K |
| 90651 |
|
179 |
172 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
815 |
801 |
$1K |
| H1004 |
Prenatal care, at-risk enhanced service; follow-up home visit |
26 |
26 |
$1K |
| 90480 |
|
58 |
58 |
$1K |
| 90633 |
|
40 |
40 |
$531.73 |
| 90715 |
|
213 |
208 |
$362.56 |
| 90710 |
|
27 |
26 |
$208.60 |
| 90473 |
|
76 |
76 |
$208.36 |
| 90674 |
|
15 |
15 |
$201.91 |
| 90672 |
|
73 |
73 |
$168.21 |
| 90619 |
|
45 |
43 |
$125.30 |
| 90734 |
|
133 |
131 |
$34.94 |
| 90656 |
|
13 |
13 |
$17.84 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |