| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,445 |
2,378 |
$233K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,720 |
1,662 |
$192K |
| S4993 |
Contraceptive pills for birth control |
1,249 |
1,238 |
$139K |
| J3490 |
Unclassified drugs |
3,314 |
2,589 |
$104K |
| 99201 |
|
550 |
547 |
$65K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
429 |
426 |
$64K |
| 87806 |
|
1,620 |
1,319 |
$38K |
| 58300 |
|
383 |
193 |
$32K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
50 |
50 |
$31K |
| 99401 |
|
1,509 |
1,492 |
$29K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
30 |
30 |
$24K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
27 |
27 |
$21K |
| 99402 |
|
644 |
640 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
225 |
216 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
915 |
895 |
$12K |
| A4267 |
Contraceptive supply, condom, male, each |
1,555 |
1,533 |
$12K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
793 |
793 |
$10K |
| 11976 |
|
139 |
70 |
$6K |
| 81025 |
|
2,243 |
2,195 |
$6K |
| 11981 |
|
27 |
27 |
$5K |
| S5000 |
Prescription drug, generic |
775 |
727 |
$4K |
| 83986 |
|
1,553 |
1,494 |
$4K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,240 |
1,190 |
$4K |
| 99000 |
|
1,292 |
1,272 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
392 |
362 |
$1K |
| 81002 |
|
542 |
518 |
$782.50 |
| 58301 |
|
30 |
15 |
$745.13 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
282 |
280 |
$528.02 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
262 |
260 |
$137.95 |
| 85018 |
|
153 |
151 |
$84.86 |
| 90630 |
|
13 |
13 |
$24.80 |
| 90688 |
|
33 |
33 |
$22.30 |
| 90715 |
|
13 |
13 |
$9.00 |
| 90686 |
|
30 |
30 |
$5.63 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
147 |
146 |
$0.00 |