| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,734 |
1,607 |
$109K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,198 |
1,158 |
$9K |
| 99403 |
|
93 |
90 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
965 |
916 |
$6K |
| 81025 |
|
488 |
475 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
702 |
686 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42 |
29 |
$521.36 |
| 90715 |
|
184 |
181 |
$466.00 |
| 90686 |
|
108 |
101 |
$217.72 |
| 90710 |
|
76 |
72 |
$147.50 |
| 90651 |
|
87 |
86 |
$144.00 |
| 87210 |
|
12 |
12 |
$101.14 |
| 90670 |
|
43 |
41 |
$46.50 |
| 90633 |
|
30 |
29 |
$5.50 |
| 90734 |
|
15 |
15 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |