| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,713 |
10,114 |
$743K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
2,543 |
1,341 |
$440K |
| T1001 |
Nursing assessment / evaluation |
2,000 |
1,200 |
$343K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,594 |
4,485 |
$212K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
6,578 |
6,482 |
$181K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,334 |
1,314 |
$143K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,977 |
1,945 |
$94K |
| 99501 |
|
946 |
912 |
$84K |
| 81025 |
|
11,075 |
10,751 |
$72K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,621 |
4,587 |
$63K |
| 99201 |
|
973 |
955 |
$27K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
65 |
63 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,436 |
1,420 |
$23K |
| 99502 |
|
109 |
82 |
$18K |
| 11981 |
|
179 |
175 |
$16K |
| S4993 |
Contraceptive pills for birth control |
1,162 |
1,142 |
$15K |
| 11982 |
|
120 |
119 |
$13K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
3,788 |
3,693 |
$12K |
| 90461 |
|
605 |
597 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
114 |
111 |
$8K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
243 |
240 |
$7K |
| 58300 |
|
13 |
13 |
$691.44 |
| 90715 |
|
199 |
193 |
$503.85 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
14 |
14 |
$266.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14 |
14 |
$266.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
387 |
376 |
$255.01 |
| 90686 |
|
96 |
93 |
$32.84 |
| 90651 |
|
82 |
81 |
$0.00 |
| 90734 |
|
67 |
67 |
$0.00 |
| 90710 |
|
25 |
25 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |