| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
219,372 |
197,091 |
$1.17M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,662 |
1,393 |
$176K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,327 |
1,614 |
$57K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
782 |
498 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
126 |
102 |
$20K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,975 |
1,323 |
$18K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
851 |
641 |
$13K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
637 |
442 |
$12K |
| 81025 |
|
820 |
570 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
2,356 |
1,435 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
45 |
40 |
$5K |
| 99385 |
|
36 |
30 |
$4K |
| 81000 |
|
1,671 |
950 |
$4K |
| 85018 |
|
1,460 |
957 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,588 |
1,136 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,575 |
1,130 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$1K |
| 76801 |
|
16 |
12 |
$1K |
| 86780 |
|
166 |
82 |
$1K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
130 |
63 |
$832.82 |
| 86703 |
|
148 |
70 |
$701.75 |
| 90688 |
|
178 |
122 |
$324.00 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
494 |
377 |
$317.20 |
| 81002 |
|
189 |
88 |
$233.52 |
| 90734 |
|
234 |
177 |
$133.90 |
| 86803 |
|
144 |
96 |
$54.45 |
| 87340 |
|
409 |
288 |
$41.54 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
473 |
332 |
$41.04 |
| 90715 |
|
91 |
63 |
$40.11 |
| 87210 |
|
57 |
27 |
$33.95 |
| 86592 |
|
1,190 |
806 |
$32.52 |
| 86850 |
|
396 |
267 |
$27.00 |
| 90658 |
|
121 |
73 |
$24.00 |
| 83655 |
|
127 |
99 |
$15.39 |
| 86787 |
|
57 |
43 |
$15.00 |
| 86900 |
|
436 |
303 |
$11.37 |
| 86901 |
|
438 |
303 |
$11.37 |
| 90686 |
|
60 |
45 |
$9.00 |
| 83020 |
|
56 |
42 |
$0.00 |
| 99173 |
|
35 |
27 |
$0.00 |
| 86701 |
|
1,200 |
812 |
$0.00 |
| 86762 |
|
41 |
29 |
$0.00 |
| 90674 |
|
71 |
47 |
$0.00 |
| 90651 |
|
25 |
13 |
$0.00 |
| 92551 |
|
18 |
15 |
$0.00 |