| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,082 |
2,848 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
354 |
293 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
502 |
407 |
$28K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,006 |
965 |
$22K |
| 99401 |
|
1,741 |
1,508 |
$11K |
| 81025 |
|
1,079 |
836 |
$7K |
| 90688 |
|
1,127 |
1,021 |
$3K |
| S4993 |
Contraceptive pills for birth control |
28 |
26 |
$3K |
| 90715 |
|
179 |
174 |
$2K |
| 90707 |
|
29 |
27 |
$2K |
| 90716 |
|
15 |
13 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
12 |
$1K |
| 91322 |
|
23 |
21 |
$1K |
| G9006 |
Coordinated care fee, home monitoring |
91 |
53 |
$994.00 |
| 90651 |
|
41 |
40 |
$866.00 |
| 90746 |
|
14 |
12 |
$764.39 |
| 90480 |
|
30 |
28 |
$672.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$590.16 |
| 90686 |
|
71 |
69 |
$581.10 |
| 90713 |
|
18 |
16 |
$469.04 |
| 87210 |
|
126 |
116 |
$368.14 |
| 90734 |
|
14 |
13 |
$116.30 |
| 36415 |
Collection of venous blood by venipuncture |
53 |
43 |
$65.03 |
| A4267 |
Contraceptive supply, condom, male, each |
306 |
223 |
$51.72 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
30 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
24 |
24 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
12 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |