| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
959 |
935 |
$782K |
| S4993 |
Contraceptive pills for birth control |
3,680 |
3,621 |
$678K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,116 |
7,280 |
$427K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
9,734 |
9,636 |
$390K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
9,704 |
9,609 |
$380K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,977 |
9,428 |
$354K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,909 |
2,825 |
$203K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
175 |
163 |
$145K |
| J3490 |
Unclassified drugs |
5,516 |
5,308 |
$137K |
| 90651 |
|
606 |
596 |
$123K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,181 |
1,096 |
$98K |
| A4267 |
Contraceptive supply, condom, male, each |
7,218 |
7,035 |
$83K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,744 |
2,513 |
$71K |
| 87806 |
|
2,986 |
2,968 |
$61K |
| 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 |
103 |
103 |
$60K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
727 |
619 |
$43K |
| 90674 |
|
1,284 |
1,271 |
$37K |
| 81025 |
|
11,336 |
10,906 |
$34K |
| 96156 |
|
368 |
364 |
$23K |
| 99385 |
|
499 |
471 |
$23K |
| Q3014 |
Telehealth originating site facility fee |
1,252 |
1,186 |
$23K |
| 11976 |
|
337 |
159 |
$17K |
| 11981 |
|
76 |
69 |
$15K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,006 |
986 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
650 |
629 |
$11K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
2,523 |
2,481 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
86 |
84 |
$9K |
| 83986 |
|
2,524 |
2,482 |
$8K |
| 99000 |
|
2,199 |
2,154 |
$6K |
| 90715 |
|
118 |
118 |
$5K |
| S0190 |
Mifepristone, oral, 200 mg |
62 |
62 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
69 |
59 |
$3K |
| 96150 |
|
226 |
225 |
$3K |
| 81002 |
|
1,440 |
1,401 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,535 |
1,496 |
$2K |
| 86580 |
|
191 |
183 |
$2K |
| 96127 |
|
452 |
418 |
$2K |
| 58300 |
|
24 |
12 |
$1K |
| 90707 |
|
12 |
12 |
$960.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
525 |
519 |
$928.63 |
| 58301 |
|
24 |
12 |
$868.66 |
| 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 |
61 |
60 |
$830.42 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
142 |
141 |
$761.36 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
74 |
74 |
$472.13 |
| 93000 |
|
19 |
19 |
$453.17 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
360 |
359 |
$240.51 |
| S0191 |
Misoprostol, oral, 200 mcg |
62 |
62 |
$212.46 |
| 85018 |
|
327 |
320 |
$206.82 |
| 87430 |
|
12 |
12 |
$167.30 |
| S5000 |
Prescription drug, generic |
2,169 |
1,845 |
$11.79 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
672 |
671 |
$0.93 |
| 1159F |
|
1,433 |
1,433 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,117 |
1,078 |
$0.00 |
| 3078F |
|
1,111 |
1,111 |
$0.00 |
| S5001 |
Prescription drug, brand name |
174 |
172 |
$0.00 |
| 1160F |
|
1,434 |
1,434 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
405 |
405 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
14 |
14 |
$0.00 |
| 4004F |
|
12 |
12 |
$0.00 |
| 1036F |
|
1,136 |
1,136 |
$0.00 |
| 3074F |
|
1,122 |
1,122 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
266 |
266 |
$0.00 |
| 3008F |
|
405 |
405 |
$0.00 |
| 2000F |
|
512 |
509 |
$0.00 |