| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,143 |
4,266 |
$464K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,585 |
5,168 |
$365K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,061 |
5,741 |
$262K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,047 |
5,657 |
$164K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,289 |
3,123 |
$127K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
1,027 |
1,027 |
$96K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,809 |
4,843 |
$62K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
714 |
621 |
$61K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
969 |
890 |
$54K |
| 86703 |
|
3,972 |
3,764 |
$45K |
| 81025 |
|
7,015 |
6,293 |
$45K |
| S4993 |
Contraceptive pills for birth control |
716 |
683 |
$31K |
| 87210 |
|
6,746 |
6,245 |
$29K |
| 82120 |
|
6,728 |
6,230 |
$28K |
| 83986 |
|
6,785 |
6,284 |
$21K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$12K |
| 99442 |
|
238 |
225 |
$5K |
| 81002 |
|
1,719 |
1,568 |
$4K |
| 90756 |
|
93 |
70 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
819 |
719 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
173 |
137 |
$2K |
| 99201 |
|
84 |
80 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
16 |
$938.67 |
| 11981 |
|
12 |
12 |
$879.55 |
| 90661 |
|
14 |
14 |
$536.14 |
| 99441 |
|
39 |
39 |
$451.36 |
| 99401 |
|
13 |
12 |
$288.31 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
94 |
93 |
$74.91 |
| 36416 |
|
102 |
97 |
$43.56 |
| A4267 |
Contraceptive supply, condom, male, each |
39 |
14 |
$19.20 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
14 |
14 |
$0.00 |