| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
1,630 |
1,317 |
$222K |
| 87806 |
|
1,174 |
929 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
265 |
217 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
258 |
225 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
185 |
166 |
$8K |
| 81025 |
|
1,069 |
885 |
$8K |
| 90651 |
|
26 |
24 |
$6K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
546 |
499 |
$6K |
| 87210 |
|
658 |
265 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
16 |
14 |
$3K |
| A4550 |
Surgical trays |
131 |
98 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
13 |
$1K |
| 58300 |
|
34 |
24 |
$1K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
17 |
15 |
$1K |
| 83986 |
|
329 |
265 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
12 |
$864.00 |
| 36415 |
Collection of venous blood by venipuncture |
311 |
266 |
$711.27 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
24 |
$488.47 |
| 99050 |
|
96 |
82 |
$440.37 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
13 |
12 |
$360.00 |
| 99459 |
|
15 |
15 |
$334.88 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
23 |
21 |
$325.71 |
| 99000 |
|
49 |
24 |
$146.40 |