| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
73,835 |
72,515 |
$382K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
449 |
405 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
667 |
574 |
$10K |
| 0001A |
|
181 |
141 |
$9K |
| 0002A |
|
181 |
133 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
226 |
193 |
$6K |
| 0012A |
|
86 |
86 |
$6K |
| 0011A |
|
102 |
100 |
$4K |
| 0071A |
|
84 |
42 |
$4K |
| 0072A |
|
40 |
28 |
$2K |
| 90651 |
|
112 |
87 |
$2K |
| 81025 |
|
228 |
201 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
74 |
67 |
$1K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
28 |
24 |
$1K |
| 90734 |
|
102 |
83 |
$923.02 |
| 90619 |
|
105 |
91 |
$795.81 |
| 90686 |
|
180 |
163 |
$765.55 |
| T1002 |
Rn services, up to 15 minutes |
13 |
13 |
$501.93 |
| 90715 |
|
111 |
89 |
$315.54 |
| 87210 |
|
61 |
59 |
$269.40 |
| 82120 |
|
61 |
59 |
$226.99 |
| 90656 |
|
41 |
37 |
$224.38 |
| 36415 |
Collection of venous blood by venipuncture |
86 |
77 |
$192.51 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
119 |
115 |
$0.00 |
| 91300 |
|
414 |
301 |
$0.00 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
41 |
40 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
119 |
115 |
$0.00 |
| 99000 |
|
176 |
160 |
$0.00 |
| 91307 |
|
124 |
66 |
$0.00 |
| 86593 |
|
62 |
59 |
$0.00 |
| 86701 |
|
47 |
46 |
$0.00 |
| 91301 |
|
199 |
197 |
$0.00 |