| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
874 |
723 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
337 |
278 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
185 |
179 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
140 |
114 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
263 |
254 |
$1K |
| D1206 |
Topical application of fluoride varnish |
67 |
67 |
$1K |
| D0191 |
|
67 |
67 |
$655.20 |
| D1330 |
|
68 |
68 |
$578.16 |
| 90686 |
|
36 |
36 |
$148.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$66.00 |
| 81025 |
|
14 |
13 |
$62.40 |