| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 59426 |
|
1,283 |
1,255 |
$1.08M |
| T1015 |
Clinic visit/encounter, all-inclusive |
13,505 |
12,744 |
$784K |
| 59430 |
|
1,282 |
1,275 |
$95K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,624 |
1,619 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,544 |
3,421 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,288 |
1,286 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,610 |
1,594 |
$11K |
| 90715 |
|
394 |
391 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
811 |
810 |
$6K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,900 |
1,786 |
$6K |
| 59425 |
|
14 |
13 |
$5K |
| 90678 |
|
12 |
12 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
181 |
180 |
$2K |
| 90686 |
|
126 |
126 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
932 |
858 |
$2K |
| 81025 |
|
1,704 |
1,670 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
903 |
875 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
25 |
$422.49 |
| 80305 |
|
348 |
348 |
$416.18 |
| 90656 |
|
18 |
18 |
$326.74 |
| 99215 |
Prolong outpt/office vis |
24 |
24 |
$314.77 |
| 99459 |
|
72 |
71 |
$101.36 |
| 96127 |
|
76 |
75 |
$90.21 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
43 |
43 |
$52.41 |
| 81003 |
|
26 |
26 |
$13.09 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
12 |
12 |
$0.00 |