| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
22,159 |
14,576 |
$683K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,494 |
17,277 |
$586K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74,538 |
50,526 |
$564K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,222 |
6,105 |
$277K |
| 99385 |
|
4,369 |
2,823 |
$152K |
| 11981 |
|
2,072 |
1,702 |
$129K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,791 |
5,851 |
$126K |
| 11982 |
|
2,299 |
1,637 |
$112K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,729 |
1,521 |
$96K |
| 99384 |
|
1,615 |
1,319 |
$92K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,317 |
1,725 |
$92K |
| 81025 |
|
17,426 |
15,194 |
$87K |
| 90651 |
|
1,565 |
1,050 |
$83K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,142 |
1,114 |
$83K |
| 11983 |
|
820 |
596 |
$77K |
| T1001 |
Nursing assessment / evaluation |
7,002 |
5,354 |
$67K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,057 |
1,686 |
$57K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,225 |
991 |
$44K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,821 |
1,500 |
$39K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,826 |
1,504 |
$39K |
| 58300 |
|
964 |
782 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,571 |
2,313 |
$26K |
| 58301 |
|
589 |
440 |
$24K |
| S4993 |
Contraceptive pills for birth control |
3,256 |
2,245 |
$24K |
| 36415 |
Collection of venous blood by venipuncture |
60,228 |
15,474 |
$21K |
| 99386 |
|
364 |
234 |
$15K |
| 86703 |
|
1,967 |
1,790 |
$11K |
| 86318 |
|
1,291 |
1,089 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
937 |
755 |
$8K |
| 87210 |
|
2,302 |
1,975 |
$7K |
| 90688 |
|
825 |
511 |
$5K |
| 90636 |
|
597 |
104 |
$4K |
| 86780 |
|
137 |
133 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
29,283 |
5,228 |
$932.81 |
| 99201 |
|
36 |
33 |
$664.47 |
| 81002 |
|
120 |
107 |
$223.52 |
| 85018 |
|
73 |
47 |
$89.68 |
| A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
301 |
71 |
$87.17 |
| 88142 |
|
53 |
38 |
$64.12 |
| 90715 |
|
82 |
64 |
$0.00 |
| 90734 |
|
265 |
214 |
$0.00 |
| 90633 |
|
213 |
175 |
$0.00 |
| J7296 |
Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg |
67 |
31 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
50 |
46 |
$0.00 |
| 90620 |
|
151 |
115 |
$0.00 |
| J0456 |
Injection, azithromycin, 500 mg |
1,194 |
498 |
$0.00 |
| 3079F |
|
229 |
173 |
$0.00 |
| 90632 |
|
467 |
264 |
$0.00 |
| 00000 |
|
77 |
69 |
$0.00 |
| 3075F |
|
47 |
39 |
$0.00 |
| 90686 |
|
32 |
19 |
$0.00 |