| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
1,349 |
929 |
$115K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,300 |
1,253 |
$53K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
379 |
378 |
$25K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
831 |
799 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
240 |
236 |
$16K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
351 |
348 |
$10K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
350 |
347 |
$10K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
353 |
347 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
320 |
319 |
$7K |
| 81025 |
|
287 |
284 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
214 |
212 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
25 |
25 |
$1K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
17 |
17 |
$510.51 |
| 86780 |
|
29 |
29 |
$484.30 |
| 59025 |
Fetal non-stress test |
22 |
12 |
$398.68 |
| S4993 |
Contraceptive pills for birth control |
13 |
13 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |