| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
99,395 |
97,409 |
$483K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,566 |
2,188 |
$35K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
636 |
599 |
$20K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
866 |
743 |
$17K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
291 |
274 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
92 |
76 |
$6K |
| 0012A |
|
64 |
61 |
$4K |
| 0011A |
|
91 |
84 |
$3K |
| T1002 |
Rn services, up to 15 minutes |
40 |
37 |
$2K |
| 90734 |
|
492 |
397 |
$2K |
| 0001A |
|
29 |
29 |
$2K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
26 |
25 |
$2K |
| 90715 |
|
358 |
293 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$1K |
| 81025 |
|
193 |
167 |
$1K |
| 90686 |
|
486 |
414 |
$814.56 |
| 0002A |
|
12 |
12 |
$780.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
62 |
57 |
$560.00 |
| 90619 |
|
339 |
303 |
$491.26 |
| 36415 |
Collection of venous blood by venipuncture |
170 |
152 |
$449.67 |
| 81003 |
|
140 |
98 |
$337.39 |
| 90688 |
|
22 |
20 |
$316.73 |
| 96127 |
|
55 |
52 |
$208.27 |
| 85018 |
|
60 |
59 |
$133.69 |
| 87210 |
|
14 |
12 |
$48.50 |
| 82120 |
|
14 |
12 |
$43.02 |
| 90656 |
|
12 |
12 |
$20.53 |
| 92551 |
|
60 |
55 |
$8.27 |
| 99173 |
|
98 |
89 |
$1.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
119 |
115 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
131 |
125 |
$0.00 |
| 91301 |
|
158 |
144 |
$0.00 |
| 86592 |
|
118 |
115 |
$0.00 |
| 88142 |
|
12 |
12 |
$0.00 |
| 90651 |
|
15 |
14 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
134 |
128 |
$0.00 |
| 91300 |
|
67 |
52 |
$0.00 |
| 90710 |
|
15 |
13 |
$0.00 |
| 99001 |
|
13 |
12 |
$0.00 |