| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,696 |
2,622 |
$257K |
| J3490 |
Unclassified drugs |
3,015 |
2,942 |
$115K |
| 87806 |
|
4,021 |
4,011 |
$114K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
878 |
876 |
$111K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,234 |
1,199 |
$84K |
| 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 |
123 |
123 |
$77K |
| S4993 |
Contraceptive pills for birth control |
668 |
661 |
$75K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
942 |
939 |
$44K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
167 |
167 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
284 |
283 |
$37K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
28 |
28 |
$32K |
| 86780 |
|
2,580 |
2,577 |
$29K |
| A4267 |
Contraceptive supply, condom, male, each |
1,277 |
1,271 |
$15K |
| S5000 |
Prescription drug, generic |
941 |
871 |
$11K |
| A4649 |
Surgical supply; miscellaneous |
697 |
568 |
$10K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
759 |
759 |
$10K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
334 |
334 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
334 |
334 |
$9K |
| 81025 |
|
2,506 |
2,478 |
$8K |
| 87808 |
|
625 |
616 |
$7K |
| 11981 |
|
27 |
26 |
$6K |
| S0190 |
Mifepristone, oral, 200 mg |
80 |
80 |
$5K |
| 83986 |
|
898 |
880 |
$3K |
| 11976 |
|
28 |
14 |
$3K |
| 87210 |
|
422 |
407 |
$2K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
37 |
36 |
$2K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
231 |
228 |
$847.46 |
| 58301 |
|
24 |
12 |
$773.04 |
| 81002 |
|
131 |
125 |
$300.15 |
| 86803 |
|
13 |
13 |
$183.49 |
| S0191 |
Misoprostol, oral, 200 mcg |
82 |
81 |
$76.90 |