| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
955 |
888 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
460 |
451 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
239 |
220 |
$13K |
| 90632 |
|
196 |
196 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
492 |
465 |
$9K |
| 0012A |
|
495 |
427 |
$9K |
| 90461 |
|
123 |
122 |
$7K |
| 0011A |
|
449 |
408 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
108 |
104 |
$4K |
| 0064A |
|
166 |
113 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
109 |
99 |
$2K |
| 90633 |
|
299 |
292 |
$1K |
| 0013A |
|
50 |
50 |
$1K |
| 90734 |
|
32 |
30 |
$875.20 |
| 0031A |
|
25 |
25 |
$840.00 |
| 90686 |
|
84 |
84 |
$834.45 |
| 86580 |
|
125 |
111 |
$807.12 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
12 |
$610.77 |
| 0001A |
|
12 |
12 |
$440.00 |
| 90651 |
|
16 |
16 |
$359.40 |
| 90688 |
|
18 |
18 |
$271.00 |
| 81025 |
|
93 |
88 |
$188.63 |
| S4993 |
Contraceptive pills for birth control |
15 |
15 |
$88.39 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 91301 |
|
887 |
739 |
$0.00 |
| 0134A |
|
12 |
12 |
$0.00 |