| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
160 |
160 |
$136K |
| S4993 |
Contraceptive pills for birth control |
500 |
500 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,289 |
1,231 |
$81K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
1,571 |
1,545 |
$65K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
1,561 |
1,539 |
$59K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
634 |
634 |
$48K |
| J3490 |
Unclassified drugs |
1,536 |
1,517 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
476 |
461 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
131 |
131 |
$15K |
| A4267 |
Contraceptive supply, condom, male, each |
1,030 |
1,011 |
$11K |
| 87806 |
|
415 |
413 |
$11K |
| 81025 |
|
1,892 |
1,811 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
154 |
152 |
$5K |
| 58300 |
|
30 |
15 |
$3K |
| 11976 |
|
58 |
29 |
$2K |
| 99000 |
|
448 |
442 |
$2K |
| 11981 |
|
13 |
13 |
$2K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
356 |
355 |
$1K |
| 83986 |
|
356 |
355 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
33 |
32 |
$782.17 |
| 81002 |
|
180 |
174 |
$401.54 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
15 |
$81.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
23 |
$52.34 |
| S5000 |
Prescription drug, generic |
568 |
514 |
$3.82 |