| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,382 |
932 |
$53K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
777 |
731 |
$37K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
774 |
728 |
$37K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
508 |
482 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
715 |
647 |
$25K |
| 99201 |
|
630 |
601 |
$23K |
| 0031A |
|
291 |
277 |
$9K |
| D1206 |
Topical application of fluoride varnish |
446 |
433 |
$8K |
| 90461 |
|
92 |
86 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
340 |
302 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
268 |
258 |
$5K |
| 90632 |
|
79 |
78 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
100 |
97 |
$4K |
| 0012A |
|
141 |
135 |
$4K |
| 0011A |
|
179 |
167 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
54 |
$4K |
| 86580 |
|
353 |
317 |
$2K |
| 90688 |
|
276 |
252 |
$2K |
| 0001A |
|
59 |
56 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
656 |
606 |
$2K |
| 0002A |
|
35 |
33 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28 |
28 |
$587.86 |
| 83655 |
|
34 |
33 |
$520.20 |
| 92551 |
|
50 |
47 |
$491.62 |
| 82465 |
|
81 |
75 |
$448.41 |
| 85018 |
|
136 |
126 |
$305.35 |
| 82962 |
|
79 |
73 |
$237.78 |
| 90651 |
|
67 |
46 |
$207.30 |
| 90633 |
|
270 |
242 |
$184.00 |
| 83986 |
|
38 |
37 |
$174.42 |
| 81025 |
|
86 |
76 |
$130.90 |
| 82120 |
|
26 |
25 |
$129.36 |
| 87210 |
|
26 |
25 |
$123.60 |
| 99173 |
|
50 |
47 |
$118.44 |
| 90734 |
|
45 |
35 |
$82.00 |
| 81002 |
|
50 |
46 |
$55.20 |
| 91301 |
|
200 |
185 |
$0.01 |
| 91303 |
|
63 |
59 |
$0.00 |