| Code | Description | Claims | Beneficiaries | Total Paid |
| G9002 |
Coordinated care fee, maintenance rate |
440 |
436 |
$52K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
954 |
908 |
$15K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
405 |
388 |
$6K |
| S0215 |
Non-emergency transportation; mileage, per mile |
118 |
118 |
$3K |
| 90619 |
|
146 |
143 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
77 |
72 |
$1K |
| 90715 |
|
118 |
110 |
$1K |
| 81025 |
|
173 |
162 |
$1K |
| 90651 |
|
89 |
86 |
$908.83 |
| 90633 |
|
14 |
14 |
$177.78 |
| 90734 |
|
26 |
26 |
$175.36 |
| 86580 |
|
28 |
25 |
$157.28 |
| 99000 |
|
64 |
55 |
$91.04 |
| 81003 |
|
34 |
30 |
$73.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$63.04 |
| 85018 |
|
18 |
14 |
$30.42 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
12 |
$26.97 |
| 96160 |
|
17 |
13 |
$21.38 |