| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9002 |
Coordinated care fee, maintenance rate |
1,247 |
1,197 |
$137K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,755 |
2,567 |
$42K |
| 90686 |
|
1,101 |
1,065 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
64 |
64 |
$4K |
| 90651 |
|
166 |
161 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
104 |
98 |
$4K |
| 90715 |
|
230 |
224 |
$3K |
| 81025 |
|
436 |
388 |
$3K |
| 90734 |
|
166 |
165 |
$2K |
| 90619 |
|
116 |
114 |
$2K |
| 99000 |
|
1,108 |
1,032 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
408 |
398 |
$1K |
| 90632 |
|
42 |
41 |
$1K |
| 90672 |
|
68 |
67 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 90656 |
|
60 |
59 |
$811.15 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
117 |
113 |
$804.89 |
| S9446 |
Patient education, not otherwise classified, non-physician provider, group, per session |
144 |
128 |
$740.00 |
| 36415 |
Collection of venous blood by venipuncture |
187 |
171 |
$450.35 |
| S4993 |
Contraceptive pills for birth control |
38 |
26 |
$401.40 |
| 92551 |
|
31 |
26 |
$247.07 |
| 90633 |
|
15 |
15 |
$210.78 |
| 91200 |
|
13 |
13 |
$180.79 |
| 86580 |
|
22 |
16 |
$176.00 |
| 99173 |
|
80 |
70 |
$148.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$141.55 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
22 |
14 |
$93.08 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
12 |
$59.80 |
| 96160 |
|
14 |
13 |
$41.42 |