| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2315 |
Injection, naltrexone, depot form, 1 mg |
4,223 |
3,591 |
$3.82M |
| 99401 |
|
6,450 |
5,559 |
$142K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,814 |
1,565 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,562 |
2,211 |
$88K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,088 |
957 |
$86K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,842 |
4,131 |
$53K |
| 80305 |
|
4,635 |
3,673 |
$32K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,175 |
1,010 |
$13K |
| 90632 |
|
192 |
182 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
735 |
641 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
346 |
336 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
98 |
91 |
$7K |
| 81025 |
|
546 |
492 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
74 |
66 |
$3K |
| 90686 |
|
252 |
224 |
$2K |
| 80306 |
|
568 |
361 |
$2K |
| 99406 |
|
164 |
144 |
$1K |
| 81002 |
|
952 |
860 |
$1K |
| G0477 |
Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service |
254 |
163 |
$893.45 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$449.07 |
| 90734 |
|
246 |
240 |
$270.28 |
| G0397 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
16 |
13 |
$197.86 |
| G0396 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes |
56 |
44 |
$179.10 |
| 99408 |
|
82 |
67 |
$150.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
50 |
43 |
$150.00 |
| 90715 |
|
79 |
71 |
$142.94 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
40 |
18 |
$107.86 |
| 36415 |
Collection of venous blood by venipuncture |
44 |
42 |
$86.77 |
| A4267 |
Contraceptive supply, condom, male, each |
167 |
148 |
$63.18 |
| H0049 |
Alcohol and/or drug screening |
49 |
41 |
$50.00 |
| 96160 |
|
29 |
29 |
$24.01 |
| G0008 |
Administration of influenza virus vaccine |
228 |
204 |
$24.00 |
| H0048 |
Alcohol and/or other drug testing: collection and handling only, specimens other than blood |
40 |
31 |
$8.40 |
| 90633 |
|
17 |
17 |
$0.11 |
| 90649 |
|
59 |
57 |
$0.02 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
168 |
151 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
241 |
213 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
54 |
41 |
$0.00 |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
115 |
86 |
$0.00 |