| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,106 |
3,192 |
$637K |
| 59840 |
|
221 |
220 |
$157K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,790 |
693 |
$126K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
926 |
834 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
809 |
452 |
$77K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
636 |
441 |
$71K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
647 |
315 |
$66K |
| 99201 |
|
293 |
216 |
$38K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
636 |
632 |
$28K |
| 86703 |
|
1,622 |
1,586 |
$25K |
| S0190 |
Mifepristone, oral, 200 mg |
248 |
246 |
$17K |
| 58300 |
|
83 |
83 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
793 |
783 |
$11K |
| 81025 |
|
2,096 |
2,023 |
$8K |
| 99385 |
|
24 |
24 |
$5K |
| 11981 |
|
13 |
13 |
$4K |
| S0191 |
Misoprostol, oral, 200 mcg |
203 |
198 |
$1K |
| 99406 |
|
30 |
30 |
$596.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
20 |
$378.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
176 |
175 |
$85.52 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
175 |
174 |
$18.39 |
| 87210 |
|
552 |
541 |
$16.22 |
| 83986 |
|
505 |
498 |
$9.38 |
| 81002 |
|
185 |
182 |
$5.89 |
| 85018 |
|
764 |
696 |
$3.90 |
| 36416 |
|
264 |
243 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
216 |
214 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
47 |
47 |
$0.00 |
| A4550 |
Surgical trays |
231 |
230 |
$0.00 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
32 |
32 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
47 |
47 |
$0.00 |
| 99152 |
|
164 |
163 |
$0.00 |