| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90837 |
Psychotherapy, 53 minutes with patient |
644 |
288 |
$68K |
| 90834 |
Psychotherapy, 45 minutes with patient |
435 |
237 |
$33K |
| Q3014 |
Telehealth originating site facility fee |
1,402 |
530 |
$32K |
| S4993 |
Contraceptive pills for birth control |
112 |
112 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
305 |
298 |
$16K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$10K |
| J3490 |
Unclassified drugs |
272 |
268 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
214 |
205 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
28 |
28 |
$2K |
| 81025 |
|
672 |
639 |
$2K |
| A4267 |
Contraceptive supply, condom, male, each |
129 |
129 |
$1K |
| 0011A |
|
18 |
18 |
$720.00 |
| 87806 |
|
17 |
17 |
$445.57 |
| 90674 |
|
12 |
12 |
$420.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$342.41 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
27 |
$161.00 |
| 99000 |
|
33 |
33 |
$119.79 |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
29 |
29 |
$106.14 |
| 83986 |
|
29 |
29 |
$92.22 |