| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,167 |
937 |
$61K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,147 |
1,041 |
$20K |
| T1015 |
Clinic visit/encounter, all-inclusive |
3,696 |
2,893 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,235 |
1,095 |
$16K |
| J3490 |
Unclassified drugs |
342 |
314 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
26 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
49 |
$2K |
| 81025 |
|
1,126 |
901 |
$940.60 |
| 86701 |
|
99 |
76 |
$560.81 |
| S4993 |
Contraceptive pills for birth control |
20 |
12 |
$84.56 |
| A4267 |
Contraceptive supply, condom, male, each |
15 |
13 |
$45.32 |
| 99000 |
|
112 |
77 |
$0.00 |