| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
164,442 |
67,074 |
$1.21M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,708 |
7,209 |
$642K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,735 |
10,120 |
$635K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,473 |
6,091 |
$120K |
| T1017 |
Targeted case management, each 15 minutes |
328 |
288 |
$76K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,692 |
1,365 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
329 |
282 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
367 |
310 |
$29K |
| 90686 |
|
3,907 |
3,341 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
327 |
293 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
145 |
121 |
$13K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
217 |
188 |
$12K |
| 36415 |
Collection of venous blood by venipuncture |
4,684 |
3,953 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
88 |
78 |
$9K |
| 99215 |
Prolong outpt/office vis |
66 |
57 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,746 |
1,450 |
$6K |
| 90620 |
|
65 |
52 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
426 |
341 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
521 |
443 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
268 |
203 |
$5K |
| 96127 |
|
1,017 |
841 |
$3K |
| 99442 |
|
108 |
58 |
$3K |
| 81025 |
|
287 |
207 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18 |
13 |
$1K |
| 99441 |
|
63 |
38 |
$1K |
| 0124A |
|
16 |
15 |
$1K |
| 90480 |
|
24 |
24 |
$970.96 |
| 0051A |
|
16 |
12 |
$844.00 |
| 92552 |
|
1,821 |
1,561 |
$572.79 |
| 82962 |
|
218 |
195 |
$512.47 |
| 96160 |
|
171 |
125 |
$457.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
14 |
$339.12 |
| 90670 |
|
163 |
131 |
$217.66 |
| 81002 |
|
67 |
54 |
$167.15 |
| 99173 |
|
2,078 |
1,775 |
$95.43 |
| 90688 |
|
117 |
111 |
$16.35 |
| 90647 |
|
13 |
12 |
$0.00 |
| 91305 |
|
49 |
30 |
$0.00 |
| 90651 |
|
21 |
13 |
$0.00 |
| 91300 |
|
45 |
26 |
$0.00 |
| 91312 |
|
17 |
16 |
$0.00 |
| 90685 |
|
19 |
16 |
$0.00 |