| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,577 |
1,442 |
$27K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
274 |
257 |
$16K |
| S4993 |
Contraceptive pills for birth control |
157 |
152 |
$14K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
164 |
153 |
$9K |
| 99000 |
|
677 |
657 |
$7K |
| 81025 |
|
1,298 |
1,197 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
906 |
791 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
769 |
391 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
320 |
311 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
65 |
65 |
$2K |
| 85018 |
|
689 |
647 |
$1K |
| 99385 |
|
14 |
13 |
$1K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
251 |
208 |
$825.44 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
251 |
208 |
$825.44 |
| 87210 |
|
95 |
93 |
$449.88 |
| 82948 |
|
672 |
622 |
$249.57 |
| 86701 |
|
217 |
180 |
$201.69 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$177.12 |
| A9150 |
Non-prescription drugs |
12 |
12 |
$168.00 |
| A4267 |
Contraceptive supply, condom, male, each |
51 |
33 |
$123.12 |
| 86592 |
|
214 |
180 |
$96.93 |
| 88142 |
|
78 |
63 |
$85.10 |
| 90715 |
|
133 |
119 |
$0.15 |
| 90686 |
|
12 |
12 |
$0.12 |
| 90651 |
|
86 |
76 |
$0.02 |
| 90707 |
|
12 |
12 |
$0.01 |
| 90734 |
|
174 |
157 |
$0.01 |
| 90710 |
|
66 |
57 |
$0.00 |
| 90633 |
|
141 |
126 |
$0.00 |
| 90696 |
|
58 |
49 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| J3490 |
Unclassified drugs |
13 |
13 |
$0.00 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
24 |
19 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |