| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
50,354 |
49,588 |
$305K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,189 |
943 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
340 |
282 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
109 |
104 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
108 |
104 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
26 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
101 |
94 |
$883.75 |
| 0001A |
|
38 |
18 |
$585.00 |
| 92551 |
|
198 |
137 |
$93.97 |
| 99173 |
|
303 |
231 |
$24.54 |
| 90672 |
|
74 |
62 |
$0.00 |
| 90670 |
|
15 |
12 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90734 |
|
46 |
41 |
$0.00 |
| 91300 |
|
38 |
18 |
$0.00 |
| 90686 |
|
294 |
258 |
$0.00 |
| 90660 |
|
12 |
12 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |