| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99402 |
|
6,242 |
5,823 |
$456K |
| H0004 |
Behavioral health counseling and therapy, per 15 minutes |
1,640 |
776 |
$146K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,441 |
1,428 |
$26K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,324 |
2,295 |
$23K |
| V5008 |
Hearing screening |
2,505 |
2,478 |
$23K |
| 99172 |
|
2,282 |
2,275 |
$21K |
| 0012A |
|
411 |
410 |
$15K |
| 0011A |
|
455 |
455 |
$13K |
| 36416 |
|
1,759 |
1,528 |
$11K |
| 0031A |
|
208 |
208 |
$8K |
| 83655 |
|
738 |
563 |
$6K |
| 85018 |
|
3,034 |
2,722 |
$6K |
| T1023 |
Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter |
49 |
49 |
$4K |
| 0001A |
|
108 |
107 |
$3K |
| 0002A |
|
76 |
76 |
$3K |
| 0064A |
|
59 |
59 |
$2K |
| 90686 |
|
251 |
251 |
$2K |
| T2022 |
Case management, per month |
19 |
19 |
$1K |
| 90715 |
|
212 |
212 |
$1K |
| H2000 |
Comprehensive multidisciplinary evaluation |
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74 |
71 |
$883.93 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
21 |
12 |
$747.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
33 |
31 |
$662.76 |
| 90651 |
|
65 |
64 |
$544.16 |
| 0072A |
|
14 |
14 |
$529.90 |
| 0071A |
|
14 |
14 |
$529.90 |
| 86580 |
|
25 |
24 |
$133.03 |
| 90619 |
|
46 |
46 |
$125.00 |
| 90656 |
|
15 |
15 |
$111.75 |
| 81025 |
|
15 |
15 |
$106.95 |
| 91306 |
|
59 |
59 |
$0.00 |
| 91301 |
|
887 |
870 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90677 |
|
46 |
46 |
$0.00 |
| 91307 |
|
30 |
30 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 91303 |
|
208 |
208 |
$0.00 |
| 90670 |
|
85 |
85 |
$0.00 |
| 91300 |
|
235 |
226 |
$0.00 |
| 90633 |
|
91 |
90 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |
| 90734 |
|
116 |
116 |
$0.00 |
| 90710 |
|
28 |
28 |
$0.00 |