| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,534 |
3,401 |
$511K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,557 |
3,319 |
$349K |
| J3490 |
Unclassified drugs |
9,238 |
8,090 |
$260K |
| S4993 |
Contraceptive pills for birth control |
2,241 |
2,220 |
$257K |
| 87806 |
|
10,042 |
8,397 |
$239K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,007 |
1,961 |
$129K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,233 |
1,975 |
$117K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
679 |
653 |
$97K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
307 |
307 |
$76K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
294 |
285 |
$74K |
| 59840 |
|
293 |
146 |
$41K |
| 99152 |
|
910 |
900 |
$38K |
| 99000 |
|
5,715 |
5,659 |
$21K |
| A4267 |
Contraceptive supply, condom, male, each |
2,516 |
2,507 |
$16K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
217 |
210 |
$15K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,136 |
1,136 |
$14K |
| 81025 |
|
5,264 |
5,180 |
$14K |
| S5000 |
Prescription drug, generic |
2,939 |
2,661 |
$14K |
| 83986 |
|
4,180 |
3,669 |
$12K |
| 90651 |
|
53 |
53 |
$11K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$10K |
| 99201 |
|
82 |
82 |
$9K |
| 58300 |
|
103 |
53 |
$8K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
120 |
120 |
$6K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,755 |
1,730 |
$6K |
| S5199 |
Personal care item, nos, each |
1,968 |
1,962 |
$6K |
| 99402 |
|
120 |
120 |
$4K |
| 11981 |
|
12 |
12 |
$3K |
| 82120 |
|
594 |
580 |
$2K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
13 |
12 |
$1K |
| 87210 |
|
434 |
432 |
$1K |
| 81002 |
|
528 |
520 |
$1K |
| 85018 |
|
590 |
585 |
$1K |
| 99401 |
|
52 |
51 |
$934.43 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
189 |
161 |
$929.64 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
84 |
72 |
$743.43 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
105 |
84 |
$720.83 |
| 64435 |
|
12 |
12 |
$451.02 |
| S0191 |
Misoprostol, oral, 200 mcg |
13 |
13 |
$34.84 |