| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
843 |
810 |
$86K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,553 |
2,411 |
$68K |
| A4267 |
Contraceptive supply, condom, male, each |
4,936 |
4,546 |
$61K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
775 |
769 |
$55K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
825 |
816 |
$51K |
| 81025 |
|
1,588 |
1,531 |
$11K |
| 80061 |
Lipid panel |
1,447 |
1,424 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
811 |
782 |
$10K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,177 |
1,154 |
$7K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
454 |
442 |
$6K |
| A9150 |
Non-prescription drugs |
248 |
229 |
$3K |
| 82947 |
|
1,444 |
1,419 |
$3K |
| 81003 |
|
1,231 |
1,188 |
$2K |
| 85018 |
|
730 |
709 |
$1K |
| 99385 |
|
14 |
13 |
$1K |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
43 |
43 |
$822.40 |
| 85014 |
|
426 |
415 |
$777.45 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
40 |
40 |
$737.15 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
28 |
28 |
$707.52 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
28 |
28 |
$707.52 |
| 90688 |
|
24 |
24 |
$385.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
26 |
$186.99 |
| 87210 |
|
42 |
40 |
$163.32 |
| J3490 |
Unclassified drugs |
216 |
202 |
$0.00 |