| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,103 |
4,923 |
$356K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,853 |
2,837 |
$79K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
365 |
363 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,500 |
2,446 |
$39K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
698 |
694 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
696 |
691 |
$33K |
| 81025 |
|
4,784 |
4,740 |
$31K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,058 |
2,048 |
$27K |
| 90461 |
|
667 |
659 |
$13K |
| 99201 |
|
453 |
452 |
$13K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,761 |
1,739 |
$6K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
24 |
13 |
$4K |
| T1001 |
Nursing assessment / evaluation |
19 |
13 |
$3K |
| 90715 |
|
340 |
337 |
$642.38 |
| S4993 |
Contraceptive pills for birth control |
38 |
37 |
$421.59 |
| 90686 |
|
795 |
778 |
$326.60 |
| 90651 |
|
239 |
236 |
$259.98 |
| 90734 |
|
164 |
164 |
$218.55 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
66 |
66 |
$47.82 |
| 90633 |
|
58 |
58 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| 90672 |
|
46 |
46 |
$0.00 |
| 90619 |
|
37 |
37 |
$0.00 |