| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,959 |
9,503 |
$691K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,099 |
4,976 |
$236K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,222 |
8,140 |
$227K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,179 |
2,147 |
$102K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
960 |
946 |
$100K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
6,327 |
6,270 |
$91K |
| 81025 |
|
10,826 |
10,610 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,346 |
2,315 |
$43K |
| 99201 |
|
964 |
952 |
$26K |
| 90461 |
|
925 |
913 |
$19K |
| S4993 |
Contraceptive pills for birth control |
930 |
920 |
$13K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
3,423 |
3,384 |
$11K |
| 99501 |
|
84 |
83 |
$8K |
| 11982 |
|
43 |
43 |
$4K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
45 |
43 |
$2K |
| 11981 |
|
12 |
12 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
814 |
802 |
$606.93 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
22 |
22 |
$399.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
22 |
22 |
$399.00 |
| 90734 |
|
110 |
109 |
$329.33 |
| 90715 |
|
332 |
329 |
$258.85 |
| 90686 |
|
233 |
232 |
$245.40 |
| 90670 |
|
43 |
43 |
$185.25 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
13 |
$174.46 |
| 90716 |
|
30 |
30 |
$115.04 |
| 86592 |
|
13 |
13 |
$59.41 |
| 90647 |
|
29 |
29 |
$0.00 |
| 90696 |
|
33 |
32 |
$0.00 |
| 90723 |
|
18 |
18 |
$0.00 |
| 90619 |
|
24 |
24 |
$0.00 |
| 90651 |
|
104 |
104 |
$0.00 |
| 90633 |
|
273 |
271 |
$0.00 |
| 90710 |
|
51 |
50 |
$0.00 |