| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
864 |
773 |
$20K |
| 99000 |
|
726 |
711 |
$6K |
| A4267 |
Contraceptive supply, condom, male, each |
782 |
736 |
$4K |
| 81025 |
|
1,441 |
1,296 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
122 |
112 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$912.12 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$837.96 |
| 85018 |
|
309 |
305 |
$286.53 |
| 81002 |
|
184 |
179 |
$177.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
64 |
$133.28 |
| 87210 |
|
17 |
17 |
$63.57 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$0.00 |
| 99406 |
|
72 |
71 |
$0.00 |
| 99384 |
|
67 |
67 |
$0.00 |