| D0999 | N/A | 21 | 150 | 2,140 | $260 | $2M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 59 | 2,520 | 330 | $100 | $352K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 46 | 2,630 | 430 | $90 | $268.2K |
| H0025 | Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) | 81 | 100 | 320 | $80 | $229.2K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 161 | 240 | 550 | $110 | $208.5K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 57 | 60 | 360 | $30 | $183.5K |
| H0023 | Alcohol and/or drug outreach | 22 | 190 | 360 | $60 | $163.1K |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 157 | 260 | 380 | $100 | $161.6K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 59 | 70 | 350 | $30 | $150K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 107 | 180 | 1,040 | $10 | $127.6K |