| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
944 |
847 |
$81K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
761 |
759 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
967 |
893 |
$57K |
| 81025 |
|
2,242 |
1,914 |
$21K |
| 86703 |
|
708 |
665 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
554 |
526 |
$11K |
| S4993 |
Contraceptive pills for birth control |
410 |
392 |
$9K |
| A4267 |
Contraceptive supply, condom, male, each |
1,810 |
1,613 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$4K |
| 86702 |
|
275 |
272 |
$3K |
| 86701 |
|
278 |
274 |
$3K |
| 86592 |
|
687 |
661 |
$3K |
| 87210 |
|
294 |
275 |
$2K |
| 99070 |
|
794 |
516 |
$1K |
| 90686 |
|
45 |
45 |
$968.00 |
| 92551 |
|
76 |
74 |
$771.84 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
19 |
$753.72 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$745.78 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
484 |
412 |
$630.14 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$404.95 |
| 85018 |
|
125 |
106 |
$181.82 |
| 99173 |
|
92 |
89 |
$176.02 |
| 96127 |
|
12 |
12 |
$55.20 |