| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
5,080 |
5,067 |
$2.39M |
| S4993 |
Contraceptive pills for birth control |
18,908 |
18,394 |
$1.61M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,640 |
25,092 |
$1.16M |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
2,166 |
2,155 |
$838K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
2,052 |
2,042 |
$657K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14,600 |
14,526 |
$596K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
27,331 |
27,242 |
$543K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13,576 |
13,393 |
$427K |
| 58300 |
|
5,586 |
5,458 |
$306K |
| 11981 |
|
4,307 |
4,297 |
$277K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,107 |
4,100 |
$260K |
| 81025 |
|
35,805 |
34,920 |
$238K |
| 11982 |
|
3,218 |
3,204 |
$229K |
| 86703 |
|
20,851 |
20,689 |
$224K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,545 |
2,540 |
$201K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
20,426 |
20,252 |
$174K |
| 58301 |
|
2,985 |
2,923 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,171 |
2,143 |
$146K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,341 |
1,339 |
$131K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
1,427 |
1,384 |
$130K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
10,778 |
10,668 |
$130K |
| 99385 |
|
1,235 |
1,231 |
$119K |
| 87210 |
|
16,995 |
16,638 |
$76K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
535 |
533 |
$41K |
| 11983 |
|
403 |
401 |
$36K |
| 36415 |
Collection of venous blood by venipuncture |
6,175 |
6,004 |
$21K |
| 81002 |
|
4,317 |
4,260 |
$12K |
| 99201 |
|
432 |
432 |
$10K |
| J7295 |
Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each |
180 |
176 |
$6K |
| 85018 |
|
1,743 |
1,731 |
$3K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
121 |
121 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
115 |
115 |
$2K |
| 56501 |
|
12 |
12 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
12 |
$1K |
| 81000 |
|
274 |
270 |
$801.03 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$607.38 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
531 |
527 |
$342.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$133.00 |
| 86901 |
|
13 |
12 |
$21.62 |
| 36416 |
|
1,490 |
1,473 |
$21.25 |
| 99000 |
|
13,094 |
12,072 |
$0.00 |