| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,415 |
1,283 |
$64K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
265 |
240 |
$23K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
100 |
82 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
98 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
706 |
615 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
49 |
40 |
$4K |
| 96127 |
|
376 |
304 |
$2K |
| 81025 |
|
281 |
232 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
86 |
76 |
$1K |
| 90620 |
|
15 |
13 |
$980.23 |
| 90688 |
|
204 |
180 |
$513.63 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$155.41 |
| 90734 |
|
12 |
12 |
$114.66 |
| 90685 |
|
13 |
12 |
$22.47 |
| 90686 |
|
89 |
83 |
$0.00 |