| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
383,821 |
379,923 |
$1.93M |
| 59426 |
|
430 |
360 |
$295K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,573 |
2,011 |
$286K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,119 |
4,868 |
$164K |
| T1002 |
Rn services, up to 15 minutes |
2,797 |
2,301 |
$134K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,414 |
4,328 |
$120K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,117 |
834 |
$116K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
2,237 |
1,723 |
$91K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,058 |
5,078 |
$81K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,819 |
2,040 |
$61K |
| 86592 |
|
11,262 |
8,779 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
571 |
418 |
$41K |
| 87210 |
|
9,968 |
7,690 |
$38K |
| 99385 |
|
266 |
208 |
$34K |
| 82120 |
|
9,938 |
7,664 |
$29K |
| 59430 |
|
266 |
208 |
$27K |
| 81025 |
|
4,061 |
2,869 |
$27K |
| 99383 |
|
312 |
213 |
$26K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
194 |
159 |
$23K |
| 83986 |
|
8,867 |
6,771 |
$23K |
| 36415 |
Collection of venous blood by venipuncture |
9,110 |
7,148 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,857 |
1,390 |
$16K |
| 99382 |
|
109 |
87 |
$10K |
| 85018 |
|
4,047 |
3,157 |
$10K |
| 90715 |
|
1,262 |
942 |
$9K |
| 81002 |
|
3,187 |
2,314 |
$8K |
| 96161 |
|
2,766 |
2,090 |
$8K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
6,395 |
5,150 |
$6K |
| 90734 |
|
1,726 |
1,264 |
$6K |
| 99215 |
Prolong outpt/office vis |
32 |
24 |
$5K |
| 90686 |
|
873 |
661 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,532 |
4,369 |
$3K |
| 81000 |
|
995 |
827 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
25 |
$3K |
| 0011A |
|
96 |
74 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,530 |
4,368 |
$3K |
| 0001A |
|
84 |
43 |
$3K |
| 86803 |
|
265 |
168 |
$2K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,019 |
1,588 |
$2K |
| 90651 |
|
152 |
127 |
$1K |
| 99384 |
|
20 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 96127 |
|
303 |
183 |
$885.44 |
| 99502 |
|
16 |
14 |
$780.00 |
| 0002A |
|
30 |
14 |
$732.80 |
| 90716 |
|
451 |
285 |
$729.02 |
| 83020 |
|
802 |
601 |
$626.53 |
| 96160 |
|
246 |
165 |
$559.56 |
| 92551 |
|
1,508 |
1,035 |
$518.13 |
| 86850 |
|
1,490 |
1,126 |
$445.29 |
| 99408 |
|
15 |
12 |
$338.03 |
| 87340 |
|
1,454 |
1,114 |
$313.11 |
| 83655 |
|
244 |
138 |
$225.13 |
| 87205 |
|
27 |
26 |
$120.09 |
| 99173 |
|
1,371 |
934 |
$88.00 |
| 82950 |
|
15 |
15 |
$78.52 |
| 86901 |
|
1,435 |
1,100 |
$68.76 |
| 86900 |
|
1,438 |
1,104 |
$63.19 |
| 90656 |
|
51 |
31 |
$61.59 |
| 87081 |
|
166 |
146 |
$32.34 |
| 99406 |
|
292 |
240 |
$29.47 |
| 86787 |
|
392 |
288 |
$24.08 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
482 |
399 |
$15.08 |
| 99000 |
|
9,282 |
7,064 |
$12.00 |
| 2000F |
|
2,275 |
1,747 |
$0.00 |
| 2001F |
|
2,592 |
1,991 |
$0.00 |
| A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
239 |
136 |
$0.00 |
| 82105 |
|
28 |
17 |
$0.00 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
146 |
107 |
$0.00 |
| 82677 |
|
28 |
17 |
$0.00 |
| 90696 |
|
58 |
32 |
$0.00 |
| 86762 |
|
75 |
50 |
$0.00 |
| 91301 |
|
104 |
75 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,566 |
1,253 |
$0.00 |
| 91300 |
|
205 |
73 |
$0.00 |
| A9153 |
Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified |
540 |
263 |
$0.00 |
| 99071 |
|
176 |
137 |
$0.00 |
| 87150 |
|
14 |
14 |
$0.00 |
| A4267 |
Contraceptive supply, condom, male, each |
430 |
219 |
$0.00 |
| 90707 |
|
432 |
272 |
$0.00 |
| 90670 |
|
31 |
26 |
$0.00 |
| 90633 |
|
102 |
61 |
$0.00 |
| 86336 |
|
28 |
17 |
$0.00 |
| 84702 |
|
28 |
17 |
$0.00 |