| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
4,258 |
3,071 |
$673K |
| T1015 |
Clinic visit/encounter, all-inclusive |
4,585 |
3,944 |
$528K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
72 |
72 |
$56K |
| 90620 |
|
517 |
401 |
$41K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
41 |
40 |
$34K |
| S4930 |
|
3,290 |
3,134 |
$33K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
1,298 |
1,296 |
$23K |
| 90675 |
|
76 |
32 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
894 |
702 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137 |
116 |
$7K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
186 |
136 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
185 |
135 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
40 |
40 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
962 |
932 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$935.81 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
18 |
18 |
$820.96 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
13 |
13 |
$729.00 |
| 90734 |
|
15 |
13 |
$607.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$512.89 |
| 90674 |
|
18 |
17 |
$270.00 |
| 36415 |
Collection of venous blood by venipuncture |
99 |
96 |
$212.46 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$202.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
72 |
65 |
$176.80 |
| 99401 |
|
12 |
12 |
$175.00 |
| 90756 |
|
13 |
12 |
$110.20 |
| 86580 |
|
17 |
17 |
$84.90 |
| 86592 |
|
13 |
13 |
$24.94 |