| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
12,436 |
10,002 |
$1.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,966 |
3,800 |
$274K |
| 99401 |
|
5,215 |
4,806 |
$214K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,037 |
4,105 |
$179K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,036 |
4,106 |
$179K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
4,484 |
4,434 |
$85K |
| A4267 |
Contraceptive supply, condom, male, each |
9,828 |
9,265 |
$70K |
| 86780 |
|
5,149 |
5,082 |
$68K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
554 |
540 |
$64K |
| 81025 |
|
5,861 |
5,605 |
$45K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
481 |
470 |
$31K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,414 |
1,343 |
$30K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,325 |
1,019 |
$24K |
| 81002 |
|
6,732 |
6,438 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
196 |
192 |
$18K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,190 |
1,151 |
$18K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
4,221 |
3,075 |
$17K |
| 87210 |
|
2,819 |
2,708 |
$15K |
| 36416 |
|
5,219 |
5,161 |
$15K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
29 |
27 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
251 |
245 |
$11K |
| 83986 |
|
2,091 |
2,014 |
$7K |
| 86703 |
|
629 |
578 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
71 |
$7K |
| 99072 |
|
749 |
660 |
$2K |
| 99441 |
|
19 |
19 |
$650.10 |
| 87808 |
|
29 |
29 |
$318.63 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
31 |
29 |
$21.26 |
| 98966 |
|
12 |
12 |
$0.00 |