| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
2,177 |
1,743 |
$195K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
446 |
427 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
203 |
201 |
$29K |
| A4267 |
Contraceptive supply, condom, male, each |
1,355 |
1,317 |
$20K |
| 99401 |
|
402 |
393 |
$19K |
| 81025 |
|
913 |
886 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
77 |
76 |
$7K |
| 99385 |
|
38 |
38 |
$6K |
| 87210 |
|
633 |
610 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
196 |
173 |
$3K |
| 83986 |
|
646 |
623 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
257 |
249 |
$967.18 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
63 |
53 |
$307.41 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
15 |
15 |
$209.10 |
| 81002 |
|
28 |
26 |
$93.96 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$88.40 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$88.40 |