| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
143 |
124 |
$443.52 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
32 |
32 |
$407.04 |
| S5199 |
Personal care item, nos, each |
139 |
123 |
$219.26 |
| 99000 |
|
28 |
28 |
$101.64 |