| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
320 |
309 |
$11K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
161 |
137 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
162 |
152 |
$5K |
| 99201 |
|
134 |
131 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
77 |
76 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
191 |
187 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
43 |
42 |
$1K |
| J3490 |
Unclassified drugs |
52 |
52 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
94 |
90 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
91 |
88 |
$1K |
| 81025 |
|
316 |
310 |
$1K |
| 83986 |
|
205 |
195 |
$224.82 |
| 36415 |
Collection of venous blood by venipuncture |
45 |
39 |
$48.42 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
14 |
12 |
$0.00 |
| 0502F |
|
16 |
14 |
$0.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
226 |
212 |
$0.00 |
| 99000 |
|
423 |
409 |
$0.00 |