| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,222 |
20,134 |
$1.23M |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
919 |
854 |
$701K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
22,869 |
17,348 |
$563K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
22,869 |
17,357 |
$563K |
| S4993 |
Contraceptive pills for birth control |
6,425 |
5,728 |
$348K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
4,187 |
3,813 |
$91K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
151 |
143 |
$75K |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
361 |
320 |
$60K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,145 |
1,056 |
$56K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,103 |
1,777 |
$53K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
817 |
756 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
502 |
471 |
$39K |
| 81025 |
|
4,486 |
4,212 |
$31K |
| 86703 |
|
1,243 |
1,172 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
264 |
255 |
$13K |
| 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 |
26 |
25 |
$13K |
| 59840 |
|
66 |
53 |
$8K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
103 |
91 |
$6K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
143 |
104 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
344 |
322 |
$4K |
| S0190 |
Mifepristone, oral, 200 mg |
42 |
38 |
$3K |
| 87210 |
|
658 |
622 |
$3K |
| 96127 |
|
756 |
573 |
$2K |
| 99000 |
|
9,364 |
8,338 |
$2K |
| 83986 |
|
462 |
431 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
360 |
336 |
$1K |
| 58300 |
|
24 |
24 |
$995.04 |
| 85018 |
|
265 |
245 |
$705.20 |
| 86901 |
|
209 |
187 |
$674.33 |
| 99406 |
|
51 |
49 |
$522.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
77 |
69 |
$338.64 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
34 |
28 |
$223.20 |
| A4550 |
Surgical trays |
276 |
269 |
$111.42 |
| 87529 |
|
28 |
14 |
$98.04 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
78 |
73 |
$34.00 |
| 88300 |
|
40 |
39 |
$0.00 |
| 90674 |
|
12 |
12 |
$0.00 |
| OCINC |
|
13 |
13 |
$0.00 |