| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T5999 |
Supply, not otherwise specified |
509 |
425 |
$62K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
724 |
696 |
$40K |
| 81025 |
|
2,166 |
2,081 |
$23K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
462 |
457 |
$21K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
145 |
142 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
522 |
511 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
69 |
68 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
68 |
65 |
$5K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
158 |
158 |
$2K |
| 87210 |
|
255 |
239 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$800.07 |
| 99201 |
|
15 |
15 |
$459.76 |
| 86703 |
|
12 |
12 |
$280.08 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
62 |
49 |
$230.00 |
| 99000 |
|
1,568 |
1,312 |
$88.50 |
| 81002 |
|
12 |
12 |
$52.20 |
| 36416 |
|
376 |
348 |
$28.16 |
| 36415 |
Collection of venous blood by venipuncture |
278 |
266 |
$19.50 |