| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
517 |
452 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
441 |
364 |
$10K |
| H1000 |
Prenatal care, at-risk assessment |
192 |
124 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
129 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$957.73 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
12 |
$678.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$214.44 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$121.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
13 |
$109.58 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
14 |
14 |
$78.00 |
| 36415 |
Collection of venous blood by venipuncture |
166 |
149 |
$70.00 |
| 85018 |
|
15 |
15 |
$19.62 |
| 90656 |
|
13 |
13 |
$0.01 |
| 1036F |
|
1,991 |
1,397 |
$0.00 |
| 3074F |
|
1,064 |
864 |
$0.00 |
| 3008F |
|
2,693 |
1,956 |
$0.00 |
| 1126F |
|
286 |
214 |
$0.00 |
| 3079F |
|
87 |
63 |
$0.00 |
| 99000 |
|
52 |
41 |
$0.00 |
| 1125F |
|
12 |
12 |
$0.00 |
| 3725F |
|
167 |
120 |
$0.00 |
| 1160F |
|
697 |
562 |
$0.00 |
| 3078F |
|
769 |
532 |
$0.00 |