| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99501 |
|
3,829 |
3,767 |
$349K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,803 |
4,599 |
$333K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
797 |
779 |
$84K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,509 |
2,488 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,961 |
2,922 |
$55K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,154 |
1,141 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
958 |
946 |
$45K |
| 99201 |
|
1,185 |
1,172 |
$33K |
| 81025 |
|
3,831 |
3,773 |
$25K |
| 90461 |
|
965 |
960 |
$19K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
978 |
968 |
$13K |
| 11982 |
|
126 |
124 |
$13K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,513 |
1,482 |
$5K |
| 90716 |
|
84 |
80 |
$4K |
| 90715 |
|
737 |
729 |
$2K |
| 58300 |
|
24 |
24 |
$1K |
| 90651 |
|
395 |
394 |
$1K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
44 |
44 |
$885.63 |
| 90734 |
|
272 |
272 |
$560.09 |
| 90686 |
|
236 |
236 |
$453.46 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
16 |
16 |
$285.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
16 |
16 |
$285.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
395 |
384 |
$252.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$50.44 |
| 90619 |
|
31 |
29 |
$0.00 |
| 90696 |
|
46 |
46 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| 90633 |
|
539 |
533 |
$0.00 |
| 90710 |
|
92 |
92 |
$0.00 |
| 90713 |
|
30 |
30 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |