| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
34,469 |
32,650 |
$197K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,468 |
1,052 |
$37K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,316 |
1,770 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
107 |
92 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
412 |
339 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
76 |
49 |
$7K |
| 0071A |
|
94 |
52 |
$4K |
| 81025 |
|
671 |
470 |
$4K |
| 0072A |
|
53 |
36 |
$3K |
| 90686 |
|
959 |
763 |
$3K |
| 99385 |
|
17 |
14 |
$1K |
| 0004A |
|
23 |
13 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
436 |
342 |
$736.09 |
| 90688 |
|
74 |
58 |
$733.35 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
465 |
414 |
$612.57 |
| 90651 |
|
30 |
26 |
$468.00 |
| 81001 |
|
132 |
111 |
$423.15 |
| 87210 |
|
153 |
114 |
$329.80 |
| 90734 |
|
93 |
69 |
$296.00 |
| 90656 |
|
37 |
26 |
$257.02 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
852 |
683 |
$155.90 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
849 |
681 |
$155.90 |
| 90715 |
|
19 |
12 |
$41.68 |
| 88142 |
|
229 |
178 |
$32.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
108 |
92 |
$10.26 |
| 91300 |
|
28 |
16 |
$0.00 |
| 82120 |
|
153 |
114 |
$0.00 |
| 90619 |
|
38 |
33 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
322 |
256 |
$0.00 |
| 91307 |
|
205 |
112 |
$0.00 |
| 86592 |
|
30 |
27 |
$0.00 |