| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,386 |
1,263 |
$116K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,419 |
2,903 |
$78K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
668 |
645 |
$38K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,367 |
1,239 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
239 |
223 |
$14K |
| 81025 |
|
1,412 |
1,216 |
$9K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
316 |
281 |
$9K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
451 |
437 |
$9K |
| 81002 |
|
3,154 |
2,968 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
395 |
357 |
$5K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
380 |
368 |
$3K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
379 |
366 |
$3K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
186 |
177 |
$1K |
| S4993 |
Contraceptive pills for birth control |
13 |
13 |
$911.02 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$887.09 |
| A4267 |
Contraceptive supply, condom, male, each |
12 |
12 |
$81.60 |
| 83986 |
|
16 |
16 |
$30.90 |