| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
109,345 |
105,089 |
$555K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,568 |
1,208 |
$18K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,324 |
1,089 |
$17K |
| 90832 |
Psychotherapy, 30 minutes with patient |
108 |
55 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
402 |
302 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80 |
56 |
$5K |
| 0011A |
|
65 |
62 |
$2K |
| 0012A |
|
36 |
36 |
$2K |
| 0001A |
|
47 |
38 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
75 |
67 |
$1K |
| 81025 |
|
223 |
196 |
$1K |
| 90734 |
|
163 |
131 |
$854.61 |
| 0002A |
|
16 |
13 |
$715.00 |
| 90715 |
|
197 |
148 |
$617.22 |
| 36415 |
Collection of venous blood by venipuncture |
256 |
222 |
$609.04 |
| 90688 |
|
58 |
43 |
$277.64 |
| 90619 |
|
276 |
201 |
$160.02 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
14 |
$122.50 |
| 90686 |
|
278 |
230 |
$116.46 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
141 |
95 |
$40.90 |
| 91300 |
|
72 |
53 |
$0.00 |
| 86703 |
|
31 |
29 |
$0.00 |
| 99173 |
|
14 |
14 |
$0.00 |
| 86592 |
|
27 |
26 |
$0.00 |
| 91301 |
|
83 |
80 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |