| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
129,811 |
114,716 |
$673K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,687 |
1,244 |
$94K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,891 |
1,353 |
$19K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
430 |
337 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
291 |
209 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
39 |
25 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
182 |
149 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
42 |
$2K |
| 90686 |
|
656 |
498 |
$2K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
27 |
24 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
716 |
560 |
$1K |
| 87210 |
|
203 |
163 |
$754.71 |
| 99401 |
|
105 |
39 |
$720.42 |
| 83986 |
|
219 |
176 |
$698.99 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
337 |
268 |
$586.73 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
340 |
271 |
$485.55 |
| 85018 |
|
230 |
185 |
$480.73 |
| 96127 |
|
91 |
76 |
$311.28 |
| 82120 |
|
73 |
59 |
$257.24 |
| 92551 |
|
202 |
163 |
$245.49 |
| 90656 |
|
41 |
35 |
$225.83 |
| 81002 |
|
127 |
93 |
$169.96 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
174 |
122 |
$138.82 |
| 99173 |
|
287 |
219 |
$79.62 |
| 81003 |
|
21 |
17 |
$45.76 |
| 86592 |
|
165 |
130 |
$18.97 |
| 2000F |
|
229 |
177 |
$0.00 |
| 91301 |
|
15 |
15 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 99001 |
|
1,207 |
867 |
$0.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
33 |
25 |
$0.00 |