| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J2315 |
Injection, naltrexone, depot form, 1 mg |
926 |
843 |
$1.10M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,833 |
5,159 |
$233K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,034 |
2,674 |
$179K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,776 |
2,670 |
$72K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,729 |
1,525 |
$30K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
344 |
320 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,323 |
1,109 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,577 |
1,530 |
$27K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,744 |
1,551 |
$23K |
| 90688 |
|
1,197 |
1,169 |
$13K |
| 90632 |
|
238 |
237 |
$12K |
| 96127 |
|
3,183 |
1,862 |
$12K |
| 91320 |
|
81 |
69 |
$7K |
| 90480 |
|
132 |
112 |
$5K |
| 81025 |
|
713 |
661 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,384 |
1,249 |
$3K |
| 90686 |
|
508 |
494 |
$2K |
| 90651 |
|
305 |
298 |
$2K |
| 99401 |
|
85 |
78 |
$2K |
| 90756 |
|
67 |
49 |
$2K |
| 99215 |
Prolong outpt/office vis |
18 |
18 |
$2K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
836 |
763 |
$2K |
| 90715 |
|
394 |
386 |
$1K |
| 90734 |
|
681 |
664 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
109 |
80 |
$1K |
| 90658 |
|
81 |
81 |
$780.89 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$735.36 |
| 99406 |
|
77 |
75 |
$699.02 |
| 99442 |
|
32 |
26 |
$625.85 |
| 99441 |
|
59 |
47 |
$615.32 |
| 80305 |
|
72 |
64 |
$602.83 |
| A4268 |
Contraceptive supply, condom, female, each |
28 |
27 |
$600.00 |
| 81002 |
|
186 |
168 |
$421.21 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$135.87 |
| 90633 |
|
136 |
134 |
$10.00 |
| 90696 |
|
22 |
20 |
$0.00 |
| 90710 |
|
73 |
70 |
$0.00 |
| 90648 |
|
28 |
28 |
$0.00 |