| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
264 |
226 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
136 |
129 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,920 |
1,826 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
935 |
892 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
106 |
74 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
85 |
77 |
$2K |
| 90715 |
|
319 |
315 |
$869.00 |
| 90710 |
|
168 |
160 |
$340.98 |
| 90723 |
|
32 |
31 |
$291.50 |
| 90686 |
|
98 |
94 |
$223.54 |
| 90670 |
|
80 |
79 |
$181.50 |
| 90696 |
|
54 |
51 |
$176.00 |
| 90651 |
|
58 |
58 |
$170.50 |
| 90633 |
|
67 |
63 |
$125.50 |
| 90647 |
|
28 |
27 |
$104.50 |
| 36415 |
Collection of venous blood by venipuncture |
225 |
215 |
$3.00 |
| 1000F |
|
26 |
12 |
$0.00 |
| 1126F |
|
26 |
12 |
$0.00 |
| 1160F |
|
27 |
13 |
$0.00 |
| 1159F |
|
27 |
13 |
$0.00 |