| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
430 |
419 |
$61K |
| 99402 |
|
924 |
894 |
$29K |
| J3490 |
Unclassified drugs |
639 |
510 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
88 |
86 |
$9K |
| S4993 |
Contraceptive pills for birth control |
207 |
206 |
$8K |
| A4267 |
Contraceptive supply, condom, male, each |
870 |
846 |
$6K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
268 |
268 |
$3K |
| 99401 |
|
153 |
151 |
$3K |
| 81025 |
|
288 |
288 |
$806.40 |
| 99000 |
|
202 |
202 |
$733.26 |
| 99403 |
|
12 |
12 |
$534.12 |
| S5199 |
Personal care item, nos, each |
844 |
813 |
$473.01 |