| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,231 |
1,163 |
$178K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
38 |
38 |
$33K |
| J3490 |
Unclassified drugs |
273 |
225 |
$15K |
| 11981 |
|
37 |
37 |
$6K |
| S4993 |
Contraceptive pills for birth control |
91 |
91 |
$5K |
| A4267 |
Contraceptive supply, condom, male, each |
519 |
515 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$4K |
| 99401 |
|
141 |
139 |
$3K |
| 81025 |
|
891 |
864 |
$2K |
| 99402 |
|
27 |
27 |
$858.33 |
| S5199 |
Personal care item, nos, each |
542 |
528 |
$337.62 |
| S5001 |
Prescription drug, brand name |
27 |
27 |
$221.26 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
15 |
15 |
$41.75 |