| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
131 |
126 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
121 |
115 |
$6K |
| S0190 |
Mifepristone, oral, 200 mg |
131 |
126 |
$5K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
95 |
93 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
139 |
135 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
42 |
41 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
140 |
138 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
109 |
106 |
$687.99 |
| S0191 |
Misoprostol, oral, 200 mcg |
111 |
105 |
$426.57 |
| 81025 |
|
49 |
49 |
$271.58 |
| 85018 |
|
71 |
71 |
$149.05 |
| 99000 |
|
16 |
15 |
$56.05 |
| 86901 |
|
12 |
12 |
$30.52 |