| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,678 |
1,056 |
$104K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,247 |
2,160 |
$81K |
| 90461 |
|
631 |
604 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
408 |
322 |
$16K |
| 0012A |
|
360 |
330 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
151 |
141 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
84 |
$8K |
| 0011A |
|
369 |
326 |
$8K |
| 90651 |
|
377 |
359 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
270 |
265 |
$6K |
| 90734 |
|
622 |
599 |
$6K |
| 0031A |
|
179 |
161 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
116 |
109 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
116 |
109 |
$5K |
| 90688 |
|
575 |
567 |
$4K |
| 90715 |
|
387 |
375 |
$2K |
| 99349 |
|
25 |
12 |
$2K |
| 90633 |
|
601 |
575 |
$2K |
| 0064A |
|
71 |
41 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
81 |
45 |
$1K |
| 90686 |
|
438 |
425 |
$717.60 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
13 |
$617.28 |
| 90713 |
|
117 |
115 |
$570.40 |
| 81025 |
|
210 |
200 |
$328.60 |
| 86580 |
|
40 |
40 |
$266.76 |
| 90716 |
|
34 |
32 |
$257.60 |
| 90714 |
|
12 |
12 |
$184.90 |
| 90710 |
|
13 |
12 |
$147.20 |
| 90744 |
|
34 |
34 |
$128.80 |
| 90687 |
|
23 |
23 |
$18.40 |
| 91301 |
|
369 |
328 |
$0.01 |
| 91303 |
|
55 |
53 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
81 |
78 |
$0.00 |