| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
154,798 |
149,906 |
$758K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
219 |
111 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
113 |
97 |
$4K |
| 81025 |
|
896 |
562 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,321 |
860 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,231 |
794 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
24 |
$2K |
| 87210 |
|
1,180 |
754 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
67 |
64 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
168 |
128 |
$2K |
| 81003 |
|
1,388 |
885 |
$2K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
892 |
566 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,202 |
796 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
49 |
$945.76 |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
34 |
24 |
$850.00 |
| 86592 |
|
921 |
582 |
$305.20 |
| 96127 |
|
65 |
38 |
$176.52 |
| 83986 |
|
205 |
123 |
$155.37 |
| 82120 |
|
206 |
124 |
$90.88 |
| 88142 |
|
18 |
13 |
$21.00 |
| 86900 |
|
12 |
12 |
$0.00 |
| 99000 |
|
2,181 |
1,430 |
$0.00 |
| 87340 |
|
13 |
13 |
$0.00 |
| 86901 |
|
12 |
12 |
$0.00 |
| 90619 |
|
53 |
43 |
$0.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
52 |
40 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
13 |
$0.00 |
| 86850 |
|
13 |
13 |
$0.00 |