| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,327 |
6,919 |
$509K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,939 |
5,892 |
$164K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,794 |
2,736 |
$130K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,376 |
4,345 |
$78K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,483 |
2,446 |
$47K |
| 81025 |
|
6,491 |
6,303 |
$42K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
258 |
256 |
$28K |
| 99501 |
|
302 |
287 |
$27K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
64 |
62 |
$24K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
378 |
377 |
$18K |
| 90461 |
|
716 |
705 |
$14K |
| 99201 |
|
428 |
425 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
105 |
105 |
$7K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,928 |
1,894 |
$6K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
71 |
70 |
$5K |
| 11981 |
|
53 |
52 |
$5K |
| 11982 |
|
38 |
38 |
$4K |
| S4993 |
Contraceptive pills for birth control |
274 |
270 |
$3K |
| 90651 |
|
228 |
228 |
$921.64 |
| 90715 |
|
440 |
440 |
$348.05 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
229 |
224 |
$160.62 |
| 90734 |
|
128 |
128 |
$100.69 |
| 90686 |
|
244 |
238 |
$87.11 |
| 90710 |
|
86 |
86 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 90633 |
|
227 |
226 |
$0.00 |
| 90716 |
|
13 |
12 |
$0.00 |
| 90696 |
|
22 |
22 |
$0.00 |
| 90619 |
|
16 |
16 |
$0.00 |