| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
1,234 |
1,204 |
$185K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,682 |
1,664 |
$110K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,831 |
3,058 |
$97K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,829 |
3,055 |
$97K |
| 99385 |
|
1,222 |
1,203 |
$88K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
4,173 |
4,089 |
$63K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
824 |
817 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,682 |
1,601 |
$48K |
| A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
297 |
292 |
$41K |
| 81025 |
|
3,371 |
3,275 |
$23K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
28 |
28 |
$22K |
| A9150 |
Non-prescription drugs |
1,217 |
1,067 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,007 |
972 |
$11K |
| A4267 |
Contraceptive supply, condom, male, each |
1,384 |
1,316 |
$8K |
| 87210 |
|
1,676 |
1,627 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
307 |
288 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
376 |
372 |
$3K |
| 11981 |
|
25 |
25 |
$2K |
| 81002 |
|
607 |
590 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
81 |
74 |
$1K |
| 80061 |
Lipid panel |
292 |
292 |
$1K |
| 82947 |
|
303 |
303 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$559.92 |
| 85018 |
|
14 |
14 |
$33.15 |
| S5000 |
Prescription drug, generic |
462 |
416 |
$0.00 |
| 86592 |
|
13 |
13 |
$0.00 |
| 97802 |
|
14 |
13 |
$0.00 |