| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,161 |
4,031 |
$336K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
6,781 |
5,912 |
$206K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
6,717 |
5,906 |
$190K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
724 |
723 |
$167K |
| J3490 |
Unclassified drugs |
6,318 |
5,780 |
$161K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,115 |
1,096 |
$131K |
| 87806 |
|
5,741 |
5,254 |
$118K |
| S4993 |
Contraceptive pills for birth control |
816 |
809 |
$82K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,248 |
1,239 |
$53K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,517 |
1,514 |
$43K |
| 81025 |
|
6,856 |
6,672 |
$30K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
516 |
510 |
$29K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
87 |
87 |
$26K |
| S5199 |
Personal care item, nos, each |
2,543 |
2,532 |
$19K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
131 |
131 |
$18K |
| 99000 |
|
4,191 |
4,156 |
$13K |
| S5000 |
Prescription drug, generic |
1,151 |
1,078 |
$9K |
| A4267 |
Contraceptive supply, condom, male, each |
4,101 |
4,084 |
$9K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
682 |
678 |
$4K |
| 83986 |
|
1,190 |
1,097 |
$3K |
| 87210 |
|
684 |
673 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
76 |
75 |
$2K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
187 |
164 |
$847.83 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
49 |
49 |
$763.88 |
| 82120 |
|
242 |
237 |
$702.68 |
| 36415 |
Collection of venous blood by venipuncture |
205 |
201 |
$461.80 |
| 81002 |
|
149 |
147 |
$243.27 |
| S5001 |
Prescription drug, brand name |
61 |
61 |
$162.00 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
42 |
42 |
$152.61 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
12 |
$71.04 |