| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
293 |
283 |
$42K |
| J3490 |
Unclassified drugs |
632 |
484 |
$24K |
| 99402 |
|
579 |
554 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
28 |
$3K |
| A4267 |
Contraceptive supply, condom, male, each |
302 |
300 |
$2K |
| 81025 |
|
365 |
364 |
$1K |
| 99401 |
|
36 |
33 |
$686.52 |
| S4993 |
Contraceptive pills for birth control |
15 |
15 |
$516.82 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
16 |
16 |
$203.52 |
| S5199 |
Personal care item, nos, each |
304 |
297 |
$174.24 |