| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,857 |
669 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
641 |
267 |
$32K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,219 |
584 |
$13K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
167 |
89 |
$11K |
| S0316 |
Disease management program, follow-up/reassessment |
224 |
68 |
$6K |
| 0064A |
|
174 |
69 |
$4K |
| 81025 |
|
1,053 |
425 |
$4K |
| 0013A |
|
188 |
114 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
339 |
164 |
$2K |
| 0001A |
|
240 |
190 |
$2K |
| 0012A |
|
564 |
502 |
$1K |
| 0002A |
|
189 |
149 |
$1K |
| 0134A |
|
40 |
15 |
$1K |
| 0072A |
|
60 |
36 |
$960.00 |
| W7000 |
|
809 |
334 |
$904.64 |
| 90686 |
|
78 |
32 |
$349.01 |
| 96127 |
|
103 |
40 |
$169.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
79 |
33 |
$161.76 |
| 0124A |
|
49 |
16 |
$120.00 |
| 0011A |
|
588 |
501 |
$87.62 |
| 0004A |
|
14 |
13 |
$40.00 |
| 36415 |
Collection of venous blood by venipuncture |
41 |
27 |
$38.24 |
| 0031A |
|
94 |
85 |
$20.22 |
| 0071A |
|
42 |
42 |
$0.00 |