| Code | Description | Claims | Beneficiaries | Total Paid |
| 59840 |
|
529 |
527 |
$192K |
| 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 |
346 |
346 |
$141K |
| S0190 |
Mifepristone, oral, 200 mg |
833 |
830 |
$66K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
737 |
725 |
$53K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
333 |
328 |
$14K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
149 |
148 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
301 |
280 |
$11K |
| 81025 |
|
1,837 |
1,713 |
$10K |
| S0191 |
Misoprostol, oral, 200 mcg |
963 |
952 |
$8K |
| A4550 |
Surgical trays |
464 |
461 |
$7K |
| 64435 |
|
274 |
273 |
$7K |
| 86703 |
|
594 |
568 |
$6K |
| 76830 |
Ultrasound, transvaginal |
81 |
78 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
165 |
156 |
$4K |
| 86901 |
|
331 |
328 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
601 |
574 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$939.07 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$889.48 |
| 85018 |
|
245 |
242 |
$781.53 |
| 99201 |
|
24 |
24 |
$683.95 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
64 |
64 |
$663.67 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$559.04 |
| 36416 |
|
550 |
535 |
$529.73 |
| 87210 |
|
103 |
99 |
$468.20 |