| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90716 |
|
467 |
462 |
$58K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,427 |
2,382 |
$42K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,178 |
1,129 |
$35K |
| 91320 |
|
249 |
249 |
$25K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
258 |
116 |
$13K |
| 90480 |
|
308 |
308 |
$12K |
| 90715 |
|
696 |
696 |
$11K |
| 90746 |
|
223 |
221 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
428 |
358 |
$8K |
| 90707 |
|
109 |
107 |
$5K |
| 90713 |
|
247 |
245 |
$4K |
| 90651 |
|
129 |
128 |
$4K |
| 92579 |
|
86 |
84 |
$3K |
| 92507 |
Treatment of speech, language, voice, communication, and/or auditory processing disorder |
48 |
28 |
$3K |
| 92587 |
|
143 |
139 |
$3K |
| 92567 |
|
121 |
117 |
$2K |
| 90686 |
|
383 |
383 |
$2K |
| 92552 |
|
43 |
42 |
$1K |
| 92550 |
|
65 |
65 |
$1K |
| 90714 |
|
86 |
86 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
170 |
162 |
$1K |
| 90633 |
|
274 |
273 |
$856.98 |
| 90632 |
|
12 |
12 |
$780.00 |
| 71046 |
Radiologic examination, chest; 2 views |
24 |
24 |
$691.12 |
| 0124A |
|
15 |
15 |
$600.00 |
| 90620 |
|
12 |
12 |
$588.58 |
| 92593 |
|
14 |
14 |
$570.82 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
15 |
15 |
$350.88 |
| T1001 |
Nursing assessment / evaluation |
15 |
15 |
$311.10 |
| 90677 |
|
48 |
48 |
$240.00 |
| 81025 |
|
30 |
29 |
$229.80 |
| 90619 |
|
92 |
92 |
$155.65 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$107.64 |
| 90744 |
|
90 |
89 |
$57.62 |
| 90696 |
|
95 |
95 |
$0.00 |
| 91319 |
|
16 |
16 |
$0.00 |
| 90656 |
|
58 |
58 |
$0.00 |
| 90723 |
|
25 |
25 |
$0.00 |
| 90697 |
|
36 |
36 |
$0.00 |
| 90710 |
|
198 |
197 |
$0.00 |
| 91312 |
|
14 |
14 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |