| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,305 |
2,224 |
$144K |
| A4268 |
Contraceptive supply, condom, female, each |
4,342 |
4,039 |
$103K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,107 |
1,047 |
$31K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
160 |
157 |
$17K |
| A4267 |
Contraceptive supply, condom, male, each |
4,209 |
3,951 |
$17K |
| T5999 |
Supply, not otherwise specified |
799 |
768 |
$11K |
| S4993 |
Contraceptive pills for birth control |
489 |
465 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67 |
66 |
$6K |
| 81025 |
|
118 |
115 |
$1K |
| 85018 |
|
72 |
70 |
$285.22 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |