| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
134,817 |
128,789 |
$661K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,383 |
1,658 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
210 |
162 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
768 |
502 |
$12K |
| 0001A |
|
249 |
221 |
$8K |
| 0002A |
|
212 |
184 |
$7K |
| 0071A |
|
86 |
54 |
$3K |
| 0072A |
|
80 |
52 |
$3K |
| 96127 |
|
590 |
359 |
$2K |
| 0012A |
|
45 |
39 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
41 |
29 |
$1K |
| 90734 |
|
191 |
116 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
12 |
$1K |
| 0011A |
|
44 |
40 |
$934.10 |
| 36415 |
Collection of venous blood by venipuncture |
369 |
247 |
$861.43 |
| 90686 |
|
721 |
564 |
$638.95 |
| 92551 |
|
290 |
177 |
$565.82 |
| 80061 |
Lipid panel |
50 |
38 |
$443.04 |
| 90688 |
|
64 |
55 |
$295.91 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
38 |
$280.00 |
| 91307 |
|
178 |
106 |
$242.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$220.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$205.96 |
| 99173 |
|
266 |
174 |
$162.86 |
| 90715 |
|
95 |
59 |
$115.01 |
| 90619 |
|
130 |
92 |
$108.07 |
| 96160 |
|
76 |
44 |
$48.62 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
12 |
12 |
$20.45 |
| 99000 |
|
887 |
602 |
$0.00 |
| 91305 |
|
20 |
13 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
28 |
17 |
$0.00 |
| 36416 |
|
68 |
55 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
16 |
$0.00 |
| 91301 |
|
98 |
86 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
13 |
$0.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
1,347 |
967 |
$0.00 |
| 91300 |
|
541 |
411 |
$0.00 |
| 0004A |
|
21 |
12 |
$0.00 |