| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,127 |
2,875 |
$291K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,327 |
3,145 |
$201K |
| 81025 |
|
8,511 |
7,317 |
$88K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
302 |
296 |
$45K |
| 86703 |
|
2,441 |
2,364 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
415 |
404 |
$37K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,883 |
1,771 |
$36K |
| S4993 |
Contraceptive pills for birth control |
3,408 |
2,691 |
$28K |
| A4267 |
Contraceptive supply, condom, male, each |
4,600 |
4,163 |
$18K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,072 |
1,023 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
861 |
861 |
$14K |
| 87210 |
|
1,443 |
1,375 |
$9K |
| 86592 |
|
1,935 |
1,872 |
$7K |
| 86701 |
|
488 |
487 |
$6K |
| A4268 |
Contraceptive supply, condom, female, each |
704 |
652 |
$3K |
| 85018 |
|
494 |
472 |
$2K |
| 99070 |
|
132 |
34 |
$580.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$498.40 |
| 86702 |
|
35 |
34 |
$456.39 |
| 81002 |
|
66 |
66 |
$65.25 |
| J3490 |
Unclassified drugs |
1,018 |
947 |
$0.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,937 |
1,561 |
$0.00 |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
13 |
$0.00 |