| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
202 |
202 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
518 |
470 |
$28K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
28 |
28 |
$24K |
| J3490 |
Unclassified drugs |
632 |
621 |
$17K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
456 |
455 |
$15K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
204 |
204 |
$15K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
457 |
456 |
$14K |
| A4267 |
Contraceptive supply, condom, male, each |
403 |
394 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
136 |
134 |
$4K |
| 87806 |
|
118 |
118 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
32 |
$3K |
| 81025 |
|
663 |
630 |
$2K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
133 |
133 |
$483.12 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
39 |
39 |
$441.67 |
| 83986 |
|
134 |
134 |
$419.76 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$416.25 |
| 99000 |
|
118 |
117 |
$395.67 |
| 81002 |
|
34 |
34 |
$70.95 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$53.52 |
| S5000 |
Prescription drug, generic |
267 |
241 |
$0.37 |