| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,155 |
1,065 |
$43K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
827 |
784 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,159 |
1,056 |
$42K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
19 |
15 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
549 |
510 |
$7K |
| 99385 |
|
95 |
90 |
$5K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
533 |
508 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
125 |
118 |
$3K |
| 86701 |
|
409 |
389 |
$3K |
| 81025 |
|
412 |
375 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
448 |
427 |
$1K |
| 87210 |
|
390 |
364 |
$1K |
| 99406 |
|
144 |
138 |
$997.19 |
| 83986 |
|
398 |
370 |
$877.48 |
| 11981 |
|
14 |
12 |
$874.80 |
| A4267 |
Contraceptive supply, condom, male, each |
46 |
39 |
$170.58 |
| S0197 |
Prenatal vitamins, 30-day supply |
13 |
13 |
$0.00 |