| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,828 |
2,500 |
$149K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,664 |
1,425 |
$122K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,037 |
902 |
$62K |
| A4267 |
Contraceptive supply, condom, male, each |
10,761 |
9,222 |
$42K |
| 86703 |
|
3,059 |
2,594 |
$24K |
| 86780 |
|
2,579 |
2,209 |
$21K |
| 99000 |
|
5,947 |
5,164 |
$17K |
| 81025 |
|
2,949 |
2,559 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,296 |
1,117 |
$16K |
| 36416 |
|
3,117 |
2,654 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,489 |
3,100 |
$6K |
| S4993 |
Contraceptive pills for birth control |
1,772 |
1,384 |
$6K |
| 87210 |
|
1,600 |
1,366 |
$6K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,299 |
1,679 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
52 |
$4K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
203 |
199 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
24 |
$724.36 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
47 |
38 |
$575.80 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
293 |
247 |
$116.23 |
| J3490 |
Unclassified drugs |
32 |
29 |
$60.00 |
| 81002 |
|
18 |
14 |
$45.24 |
| 96127 |
|
12 |
12 |
$43.11 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
54 |
42 |
$34.41 |
| J0456 |
Injection, azithromycin, 500 mg |
18 |
14 |
$8.00 |