| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,243 |
6,752 |
$665K |
| 90461 |
|
7,635 |
7,612 |
$287K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,847 |
1,713 |
$239K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,228 |
10,185 |
$199K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
924 |
903 |
$163K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,499 |
5,303 |
$108K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,787 |
1,717 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
984 |
983 |
$107K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
791 |
791 |
$79K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,594 |
2,561 |
$50K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
539 |
539 |
$47K |
| 0004A |
|
864 |
864 |
$35K |
| 86580 |
|
2,854 |
2,845 |
$32K |
| 99383 |
|
217 |
217 |
$30K |
| 0002A |
|
712 |
709 |
$28K |
| 0071A |
|
676 |
675 |
$27K |
| 0001A |
|
647 |
635 |
$26K |
| 0072A |
|
627 |
627 |
$25K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
212 |
212 |
$17K |
| 59426 |
|
15 |
15 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
122 |
122 |
$15K |
| 59430 |
|
55 |
55 |
$13K |
| 0064A |
|
316 |
316 |
$13K |
| 96127 |
|
2,886 |
2,765 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
664 |
651 |
$10K |
| 0124A |
|
225 |
225 |
$9K |
| 99384 |
|
53 |
53 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
58 |
$8K |
| 82962 |
|
2,226 |
2,092 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
296 |
296 |
$6K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
133 |
133 |
$6K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
122 |
122 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
480 |
476 |
$5K |
| 81025 |
|
530 |
527 |
$5K |
| 99215 |
Prolong outpt/office vis |
52 |
51 |
$4K |
| 0134A |
|
96 |
95 |
$4K |
| 99381 |
|
25 |
25 |
$3K |
| 81000 |
|
562 |
559 |
$2K |
| 0031A |
|
51 |
51 |
$2K |
| 0003A |
|
51 |
51 |
$2K |
| 99382 |
|
14 |
14 |
$2K |
| 0013A |
|
42 |
42 |
$2K |
| 0073A |
|
33 |
33 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$1K |
| 90658 |
|
62 |
62 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
72 |
72 |
$1K |
| 84703 |
|
132 |
132 |
$992.64 |
| 0034A |
|
21 |
21 |
$840.00 |
| A4211 |
Supplies for self-administered injections |
80 |
80 |
$745.20 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
19 |
19 |
$563.85 |
| 0012A |
|
14 |
14 |
$560.00 |
| 0011A |
|
13 |
13 |
$520.00 |
| 96161 |
|
40 |
40 |
$115.22 |
| 92553 |
|
74 |
74 |
$103.46 |
| A4259 |
Lancets, per box of 100 |
69 |
69 |
$97.98 |
| 99173 |
|
99 |
99 |
$62.00 |
| 85018 |
|
13 |
13 |
$30.81 |
| 85014 |
|
13 |
13 |
$30.81 |
| 90670 |
|
14 |
14 |
$0.00 |