| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,121 |
4,885 |
$356K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,539 |
2,523 |
$70K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
294 |
287 |
$32K |
| 81025 |
|
4,389 |
4,301 |
$28K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
163 |
91 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,759 |
1,732 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
373 |
369 |
$17K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,269 |
1,263 |
$17K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
336 |
334 |
$16K |
| 99201 |
|
186 |
184 |
$5K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,528 |
1,498 |
$5K |
| 90739 |
|
29 |
29 |
$3K |
| T1001 |
Nursing assessment / evaluation |
13 |
12 |
$2K |
| 90461 |
|
98 |
98 |
$2K |
| 90716 |
|
16 |
16 |
$2K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
12 |
12 |
$229.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$146.32 |
| 90686 |
|
1,029 |
1,008 |
$82.10 |
| 90672 |
|
108 |
99 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |