| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,062 |
13,402 |
$464K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,211 |
2,118 |
$151K |
| 81025 |
|
19,303 |
16,924 |
$130K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,766 |
1,747 |
$108K |
| 99000 |
|
11,294 |
10,403 |
$102K |
| 99215 |
Prolong outpt/office vis |
1,590 |
1,524 |
$98K |
| A4267 |
Contraceptive supply, condom, male, each |
12,056 |
10,693 |
$67K |
| 99385 |
|
966 |
951 |
$63K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
913 |
888 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
985 |
952 |
$40K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,584 |
2,473 |
$28K |
| 99205 |
Prolong outpt/office vis |
270 |
264 |
$22K |
| A4268 |
Contraceptive supply, condom, female, each |
902 |
826 |
$22K |
| 76830 |
Ultrasound, transvaginal |
233 |
232 |
$20K |
| 87210 |
|
3,593 |
3,436 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
258 |
245 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
813 |
783 |
$9K |
| 81003 |
|
5,398 |
4,399 |
$8K |
| 81002 |
|
974 |
836 |
$2K |
| 11982 |
|
13 |
12 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$1K |
| 76801 |
|
18 |
16 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
17 |
$1K |
| 88142 |
|
62 |
60 |
$989.25 |
| 58301 |
|
13 |
12 |
$951.30 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$826.20 |
| 87660 |
|
80 |
76 |
$488.66 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
136 |
132 |
$345.21 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
138 |
133 |
$345.21 |
| 87088 |
|
48 |
46 |
$231.20 |
| 86702 |
|
87 |
83 |
$176.54 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
45 |
43 |
$135.42 |
| 86592 |
|
46 |
42 |
$21.09 |
| 86696 |
|
30 |
28 |
$17.50 |
| 84479 |
|
30 |
28 |
$8.75 |
| 84443 |
Thyroid stimulating hormone (TSH) |
34 |
32 |
$8.40 |
| 80053 |
Comprehensive metabolic panel |
30 |
28 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
28 |
$0.00 |
| 80061 |
Lipid panel |
30 |
28 |
$0.00 |