| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
109 |
101 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
179 |
157 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
98 |
94 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
156 |
145 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
17 |
17 |
$960.67 |
| 92552 |
|
80 |
72 |
$404.64 |
| 86580 |
|
43 |
42 |
$349.59 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
19 |
19 |
$336.14 |
| 99173 |
|
80 |
72 |
$140.50 |
| 90686 |
|
14 |
14 |
$71.92 |
| 90633 |
|
43 |
42 |
$0.00 |