| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
28,424 |
26,872 |
$146K |
| 90837 |
Psychotherapy, 53 minutes with patient |
296 |
117 |
$27K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
554 |
497 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,370 |
1,135 |
$16K |
| 81025 |
|
1,323 |
1,065 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
110 |
93 |
$8K |
| 0001A |
|
157 |
132 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
70 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
63 |
44 |
$6K |
| 99502 |
|
85 |
77 |
$5K |
| 0002A |
|
60 |
60 |
$4K |
| 0011A |
|
84 |
76 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
199 |
179 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
44 |
$3K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
57 |
53 |
$3K |
| 96127 |
|
436 |
367 |
$2K |
| 0012A |
|
31 |
30 |
$2K |
| 90686 |
|
339 |
279 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
97 |
87 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
15 |
13 |
$1K |
| 99406 |
|
111 |
85 |
$873.45 |
| 0031A |
|
18 |
18 |
$482.63 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$433.50 |
| 90734 |
|
23 |
14 |
$284.37 |
| 85018 |
|
72 |
65 |
$219.62 |
| 96161 |
|
63 |
51 |
$168.30 |
| 99401 |
|
931 |
700 |
$133.12 |
| 87210 |
|
31 |
26 |
$121.25 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
209 |
179 |
$77.01 |
| 36415 |
Collection of venous blood by venipuncture |
129 |
106 |
$73.87 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
209 |
179 |
$45.83 |
| 91300 |
|
180 |
143 |
$0.00 |
| 99173 |
|
20 |
16 |
$0.00 |
| 99000 |
|
272 |
228 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
1,262 |
952 |
$0.00 |
| 2000F |
|
39 |
28 |
$0.00 |
| 91307 |
|
21 |
13 |
$0.00 |
| 91301 |
|
111 |
103 |
$0.00 |
| 91303 |
|
13 |
13 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |