| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,591 |
4,773 |
$410K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
375 |
294 |
$85K |
| J3490 |
Unclassified drugs |
771 |
685 |
$54K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
65 |
65 |
$18K |
| A4267 |
Contraceptive supply, condom, male, each |
643 |
640 |
$9K |
| 81025 |
|
2,717 |
2,675 |
$8K |
| 86701 |
|
226 |
225 |
$1K |
| 86780 |
|
67 |
67 |
$610.13 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$0.00 |