| Code | Description | Claims | Beneficiaries | Total Paid |
| S4993 |
Contraceptive pills for birth control |
3,950 |
3,795 |
$624K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,458 |
3,376 |
$222K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,991 |
2,982 |
$201K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,250 |
5,862 |
$168K |
| 99385 |
|
1,162 |
1,158 |
$89K |
| 81025 |
|
12,292 |
11,772 |
$82K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
101 |
101 |
$81K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,185 |
2,105 |
$74K |
| J7295 |
Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each |
45 |
42 |
$67K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
31 |
31 |
$66K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,105 |
1,064 |
$62K |
| A4267 |
Contraceptive supply, condom, male, each |
21,511 |
19,525 |
$54K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,757 |
3,647 |
$41K |
| 87210 |
|
6,132 |
5,857 |
$27K |
| 99000 |
|
2,803 |
2,700 |
$27K |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
1,685 |
1,658 |
$24K |
| 90651 |
|
78 |
76 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,113 |
1,089 |
$12K |
| J3490 |
Unclassified drugs |
607 |
529 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
561 |
543 |
$10K |
| 81002 |
|
2,774 |
2,684 |
$8K |
| A4269 |
Contraceptive supply, spermicide (e.g., foam, gel), each |
509 |
501 |
$7K |
| 11981 |
|
55 |
55 |
$4K |
| 11982 |
|
40 |
38 |
$3K |
| A9150 |
Non-prescription drugs |
169 |
169 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
683 |
677 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
685 |
679 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
43 |
42 |
$1K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
406 |
390 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
116 |
$784.00 |
| 99201 |
|
36 |
36 |
$758.16 |
| 85018 |
|
170 |
156 |
$272.40 |
| 99406 |
|
221 |
218 |
$268.32 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
31 |
30 |
$60.69 |
| 88142 |
|
119 |
118 |
$17.02 |
| 86592 |
|
31 |
30 |
$10.77 |
| S5000 |
Prescription drug, generic |
549 |
512 |
$0.00 |