| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9430 |
Pharmacy compounding and dispensing services |
12,738 |
10,948 |
$742K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,274 |
8,754 |
$599K |
| S4993 |
Contraceptive pills for birth control |
11,630 |
9,379 |
$201K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,254 |
1,216 |
$129K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
899 |
851 |
$121K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
935 |
903 |
$117K |
| 81025 |
|
8,158 |
7,768 |
$106K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,837 |
1,768 |
$91K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,094 |
1,071 |
$81K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,286 |
4,076 |
$61K |
| 58300 |
|
163 |
158 |
$56K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,102 |
1,079 |
$38K |
| 86703 |
|
2,812 |
2,649 |
$33K |
| 36415 |
Collection of venous blood by venipuncture |
2,813 |
2,641 |
$32K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
95 |
89 |
$19K |
| 99385 |
|
199 |
188 |
$18K |
| 87210 |
|
3,488 |
3,346 |
$17K |
| 36416 |
|
2,310 |
2,137 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,221 |
1,130 |
$12K |
| J3490 |
Unclassified drugs |
1,248 |
1,062 |
$8K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
15 |
15 |
$6K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
40 |
40 |
$4K |
| 11981 |
|
15 |
15 |
$3K |
| 58301 |
|
40 |
39 |
$2K |
| 81002 |
|
53 |
48 |
$147.60 |
| 85018 |
|
29 |
26 |
$51.11 |
| A4550 |
Surgical trays |
24 |
22 |
$0.00 |