| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,990 |
6,646 |
$910K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,607 |
6,257 |
$582K |
| 87806 |
|
17,282 |
15,179 |
$450K |
| J3490 |
Unclassified drugs |
15,128 |
13,085 |
$449K |
| S4993 |
Contraceptive pills for birth control |
3,280 |
3,214 |
$413K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,833 |
1,783 |
$388K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,882 |
2,805 |
$368K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,280 |
1,276 |
$308K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,581 |
4,443 |
$281K |
| 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 |
593 |
591 |
$279K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
4,728 |
4,434 |
$192K |
| 90651 |
|
546 |
546 |
$120K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
118 |
118 |
$98K |
| 58300 |
|
874 |
446 |
$82K |
| A4267 |
Contraceptive supply, condom, male, each |
5,443 |
5,412 |
$47K |
| 99000 |
|
11,899 |
11,669 |
$46K |
| S0190 |
Mifepristone, oral, 200 mg |
604 |
601 |
$41K |
| 99201 |
|
417 |
414 |
$36K |
| 81025 |
|
11,968 |
11,613 |
$35K |
| 11981 |
|
142 |
142 |
$31K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
44 |
44 |
$30K |
| S5000 |
Prescription drug, generic |
4,834 |
4,197 |
$26K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,603 |
1,603 |
$20K |
| 83986 |
|
6,128 |
5,379 |
$19K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
96 |
96 |
$14K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
146 |
135 |
$13K |
| 82120 |
|
3,057 |
2,946 |
$13K |
| 58301 |
|
382 |
197 |
$11K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
2,503 |
2,430 |
$10K |
| 11976 |
|
155 |
79 |
$9K |
| 99402 |
|
281 |
280 |
$9K |
| 87210 |
|
1,896 |
1,835 |
$7K |
| S5199 |
Personal care item, nos, each |
4,970 |
4,933 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
595 |
532 |
$4K |
| 99401 |
|
189 |
189 |
$4K |
| 81002 |
|
1,393 |
1,350 |
$3K |
| S0191 |
Misoprostol, oral, 200 mcg |
543 |
535 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$790.92 |
| 85018 |
|
53 |
52 |
$105.78 |