| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4267 |
Contraceptive supply, condom, male, each |
2,950 |
2,735 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,180 |
1,112 |
$33K |
| S4993 |
Contraceptive pills for birth control |
289 |
280 |
$28K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
147 |
143 |
$9K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
119 |
117 |
$8K |
| 81025 |
|
952 |
924 |
$6K |
| 80061 |
Lipid panel |
803 |
788 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
500 |
488 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
96 |
$2K |
| 82947 |
|
806 |
791 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
140 |
131 |
$2K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
80 |
79 |
$1K |
| 81003 |
|
549 |
535 |
$976.48 |
| A9150 |
Non-prescription drugs |
36 |
36 |
$476.00 |
| 85018 |
|
219 |
210 |
$397.09 |
| G0475 |
Hiv antigen/antibody, combination assay, screening |
13 |
12 |
$257.65 |
| 85014 |
|
74 |
73 |
$137.67 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
37 |
25 |
$53.71 |
| 87210 |
|
12 |
12 |
$53.30 |
| J3490 |
Unclassified drugs |
29 |
26 |
$0.00 |