| T1015 | Clinic visit/encounter, all-inclusive | 65,390 | $120 | $8M |
| T1040 | Medicaid certified community behavioral health clinic services, per diem | 250 | $50 | $12.9K |
| 90651 | This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,… | 2,140 | $1 | $8.6K |
| 90734 | The provider administers a meningococcal conjugate vaccine in a diphtheria toxoid carrier (MenACWY–D) or CRM197 carrier (MenACWY–CRM) to protect the patient from four strains of meningococcal viruses… | 1,600 | $1 | $4.8K |
| 90633 | This code represents a vaccine product administered into a muscle to protect against hepatitis A, a liver infection. This code is specific to a pediatric/adolescent dosage with a two–dose schedule. | 1,250 | $1 | $1.2K |
| 90698 | This code represents a combination vaccine product administered into the muscle to protect against five diseases: diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), and polio. | 1,200 | $1 | $1.2K |
| 90681 | This code represents a live, weakened rotavirus vaccine given by mouth in a two–dose schedule to protect against rotavirus infection. | 630 | $1 | $630 |
| 90688 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose. | 570 | $1 | $570 |
| 90716 | The provider administers a live vaccine subcutaneously to protect against varicella infection. | 160 | $1 | $490 |
| 90707 | This code represents an MMR vaccine product administered beneath the skin to protect against measles, mumps, and rubella (German measles). | 200 | $1 | $400 |