| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
1,023 |
999 |
$162K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,584 |
1,570 |
$102K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,699 |
2,881 |
$93K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,698 |
2,880 |
$93K |
| 99385 |
|
1,241 |
1,215 |
$88K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
3,970 |
3,897 |
$58K |
| A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
245 |
238 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,485 |
1,425 |
$41K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
370 |
368 |
$26K |
| 81025 |
|
3,273 |
3,177 |
$22K |
| A9150 |
Non-prescription drugs |
1,452 |
1,145 |
$17K |
| A4267 |
Contraceptive supply, condom, male, each |
1,158 |
1,113 |
$8K |
| 87210 |
|
1,463 |
1,431 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
567 |
545 |
$6K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
233 |
232 |
$2K |
| 81002 |
|
548 |
529 |
$2K |
| 97802 |
|
798 |
785 |
$1K |
| 80061 |
Lipid panel |
307 |
303 |
$1K |
| 82947 |
|
316 |
312 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
79 |
$897.08 |
| 85018 |
|
205 |
197 |
$339.46 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$200.97 |
| 85014 |
|
98 |
93 |
$125.75 |
| 88142 |
|
12 |
12 |
$68.08 |
| S5000 |
Prescription drug, generic |
373 |
312 |
$0.00 |