| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
362,293 |
290,252 |
$1.91M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,050 |
1,591 |
$132K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,959 |
3,343 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
395 |
294 |
$36K |
| 97803 |
|
832 |
587 |
$35K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,245 |
1,069 |
$31K |
| 97802 |
|
231 |
176 |
$15K |
| 96152 |
|
254 |
179 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
121 |
$13K |
| 99502 |
|
179 |
166 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
412 |
320 |
$3K |
| 90686 |
|
1,331 |
1,174 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
24 |
$3K |
| 99501 |
|
46 |
45 |
$3K |
| 96127 |
|
235 |
197 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
833 |
691 |
$2K |
| 90651 |
|
61 |
58 |
$984.54 |
| 90734 |
|
86 |
73 |
$595.00 |
| 90715 |
|
99 |
83 |
$318.42 |
| 90656 |
|
60 |
56 |
$312.18 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
20 |
12 |
$306.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
12 |
$204.48 |
| 96160 |
|
41 |
40 |
$168.30 |
| 86787 |
|
12 |
12 |
$145.18 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14 |
13 |
$98.67 |
| 81025 |
|
13 |
12 |
$88.44 |
| 90707 |
|
35 |
26 |
$78.72 |
| 85018 |
|
30 |
25 |
$57.19 |
| 96161 |
|
14 |
14 |
$52.36 |
| 99173 |
|
138 |
120 |
$48.54 |
| 81002 |
|
14 |
14 |
$45.50 |
| 92551 |
|
91 |
79 |
$1.00 |
| 86592 |
|
62 |
52 |
$0.00 |
| 90716 |
|
33 |
26 |
$0.00 |
| 87800 |
|
14 |
12 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
62 |
52 |
$0.00 |
| 90619 |
|
28 |
27 |
$0.00 |
| 90670 |
|
53 |
49 |
$0.00 |
| 90685 |
|
17 |
16 |
$0.00 |
| 87210 |
|
17 |
14 |
$0.00 |