| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
896 |
869 |
$199K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,166 |
1,133 |
$165K |
| J3490 |
Unclassified drugs |
1,082 |
894 |
$52K |
| Z7500 |
|
1,553 |
1,494 |
$34K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
77 |
77 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
121 |
120 |
$13K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
304 |
304 |
$4K |
| A4267 |
Contraceptive supply, condom, male, each |
464 |
464 |
$4K |
| 81025 |
|
330 |
330 |
$924.00 |
| 99000 |
|
198 |
198 |
$718.74 |
| 58301 |
|
22 |
12 |
$570.90 |
| 99403 |
|
12 |
12 |
$534.12 |