| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,613 |
1,519 |
$123K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
390 |
331 |
$35K |
| A4267 |
Contraceptive supply, condom, male, each |
1,085 |
1,084 |
$13K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
51 |
44 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$3K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
151 |
151 |
$2K |
| J3490 |
Unclassified drugs |
12 |
12 |
$1K |
| 99000 |
|
285 |
284 |
$747.06 |
| 81025 |
|
26 |
26 |
$70.00 |
| 90656 |
|
17 |
17 |
$50.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
28 |
$8.08 |
| 3074F |
|
323 |
315 |
$0.00 |
| 3079F |
|
113 |
110 |
$0.00 |
| 3008F |
|
659 |
641 |
$0.00 |
| 1159F |
|
314 |
306 |
$0.00 |
| 1160F |
|
299 |
290 |
$0.00 |
| 3078F |
|
77 |
77 |
$0.00 |