| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
1,349 |
1,347 |
$1.16M |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
1,297 |
1,291 |
$961K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
993 |
991 |
$867K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,621 |
7,314 |
$821K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,702 |
4,592 |
$763K |
| J3490 |
Unclassified drugs |
17,499 |
14,479 |
$678K |
| S4993 |
Contraceptive pills for birth control |
5,382 |
5,364 |
$652K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,479 |
5,395 |
$410K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
10,219 |
9,813 |
$383K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,596 |
2,587 |
$350K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,398 |
1,398 |
$312K |
| 11981 |
|
1,375 |
1,369 |
$255K |
| 87806 |
|
9,550 |
8,534 |
$245K |
| 11976 |
|
2,800 |
1,410 |
$198K |
| 99201 |
|
2,009 |
2,002 |
$159K |
| A4267 |
Contraceptive supply, condom, male, each |
10,598 |
10,529 |
$144K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
547 |
545 |
$139K |
| S0190 |
Mifepristone, oral, 200 mg |
1,191 |
1,188 |
$72K |
| 58300 |
|
598 |
304 |
$56K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
1,727 |
1,721 |
$52K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
525 |
512 |
$42K |
| 99401 |
|
1,868 |
1,849 |
$36K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
2,386 |
2,386 |
$30K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
105 |
105 |
$28K |
| 99000 |
|
7,432 |
7,245 |
$27K |
| 81025 |
|
8,518 |
8,432 |
$27K |
| 99402 |
|
557 |
557 |
$18K |
| 58301 |
|
424 |
218 |
$17K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
5,244 |
3,732 |
$16K |
| 83986 |
|
5,329 |
4,616 |
$16K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
4,142 |
4,044 |
$16K |
| S5000 |
Prescription drug, generic |
2,018 |
1,844 |
$15K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
100 |
100 |
$13K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
15 |
15 |
$10K |
| Q3014 |
Telehealth originating site facility fee |
368 |
362 |
$9K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,006 |
954 |
$5K |
| S0191 |
Misoprostol, oral, 200 mcg |
1,384 |
1,364 |
$4K |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
162 |
162 |
$3K |
| 11982 |
|
26 |
13 |
$2K |
| 81002 |
|
901 |
879 |
$2K |
| 85018 |
|
334 |
330 |
$771.57 |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
368 |
362 |
$769.80 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
28 |
$165.42 |
| 86901 |
|
25 |
25 |
$50.75 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$0.00 |