| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,343 |
6,070 |
$1.19M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,866 |
3,277 |
$634K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
566 |
279 |
$54K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
263 |
263 |
$51K |
| 86703 |
|
2,918 |
2,906 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
364 |
214 |
$39K |
| G2011 |
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes |
735 |
735 |
$32K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
726 |
89 |
$25K |
| 81025 |
|
2,997 |
2,879 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
276 |
34 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
389 |
357 |
$7K |
| 87806 |
|
230 |
230 |
$4K |
| 96156 |
|
29 |
29 |
$860.44 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
438 |
438 |
$545.75 |
| S0190 |
Mifepristone, oral, 200 mg |
12 |
12 |
$520.25 |
| 36415 |
Collection of venous blood by venipuncture |
244 |
242 |
$302.84 |
| 81003 |
|
352 |
300 |
$22.24 |
| S0191 |
Misoprostol, oral, 200 mcg |
12 |
12 |
$8.75 |
| S5000 |
Prescription drug, generic |
47 |
46 |
$1.96 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
12 |
12 |
$0.00 |