| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9002 |
Coordinated care fee, maintenance rate |
3,976 |
3,661 |
$432K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,935 |
3,771 |
$60K |
| 90686 |
|
1,838 |
1,816 |
$22K |
| S0215 |
Non-emergency transportation; mileage, per mile |
1,940 |
1,829 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
989 |
949 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
588 |
556 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
89 |
85 |
$7K |
| 81025 |
|
664 |
627 |
$4K |
| 90632 |
|
50 |
47 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
63 |
62 |
$2K |
| 90715 |
|
99 |
99 |
$1K |
| 90656 |
|
116 |
116 |
$1K |
| 90619 |
|
86 |
85 |
$1K |
| G9001 |
Coordinated care fee, initial rate |
39 |
38 |
$1K |
| 90734 |
|
58 |
58 |
$998.75 |
| 86580 |
|
123 |
111 |
$901.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$543.18 |
| 90651 |
|
27 |
27 |
$316.57 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$244.37 |
| 99000 |
|
162 |
155 |
$156.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
58 |
56 |
$135.49 |
| S9446 |
Patient education, not otherwise classified, non-physician provider, group, per session |
25 |
25 |
$132.00 |
| 96161 |
|
12 |
12 |
$36.94 |