| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,939 |
6,600 |
$477K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,249 |
11,082 |
$204K |
| 99501 |
|
1,535 |
1,481 |
$138K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,635 |
3,602 |
$100K |
| 90461 |
|
4,127 |
4,085 |
$85K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
749 |
742 |
$78K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,360 |
1,343 |
$62K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
867 |
862 |
$41K |
| 99201 |
|
1,322 |
1,308 |
$36K |
| 81025 |
|
5,003 |
4,910 |
$32K |
| 11982 |
|
232 |
231 |
$24K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,831 |
1,810 |
$23K |
| 90716 |
|
707 |
702 |
$8K |
| 11981 |
|
72 |
71 |
$7K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,635 |
1,610 |
$5K |
| 90715 |
|
2,533 |
2,491 |
$3K |
| S4993 |
Contraceptive pills for birth control |
245 |
243 |
$3K |
| 90651 |
|
2,214 |
2,183 |
$3K |
| 90734 |
|
1,689 |
1,669 |
$2K |
| 90686 |
|
2,636 |
2,614 |
$2K |
| 90707 |
|
290 |
288 |
$973.80 |
| 90674 |
|
33 |
33 |
$541.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
141 |
140 |
$527.68 |
| 90670 |
|
1,132 |
1,129 |
$343.33 |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
16 |
16 |
$286.18 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
13 |
13 |
$247.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$247.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
367 |
360 |
$213.37 |
| 90696 |
|
653 |
648 |
$0.00 |
| 90723 |
|
726 |
724 |
$0.00 |
| 90647 |
|
1,022 |
1,020 |
$0.00 |
| 90744 |
|
24 |
24 |
$0.00 |
| 90680 |
|
261 |
259 |
$0.00 |
| 90619 |
|
433 |
421 |
$0.00 |
| 90621 |
|
264 |
263 |
$0.00 |
| 90710 |
|
1,370 |
1,361 |
$0.00 |
| 90633 |
|
2,800 |
2,780 |
$0.00 |
| 90713 |
|
376 |
376 |
$0.00 |
| 90700 |
|
844 |
841 |
$0.00 |
| 90672 |
|
90 |
88 |
$0.00 |
| 90671 |
|
17 |
17 |
$0.00 |