| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,170 |
1,078 |
$56K |
| S4993 |
Contraceptive pills for birth control |
196 |
196 |
$39K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
27 |
25 |
$33K |
| 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 |
36 |
36 |
$22K |
| J3490 |
Unclassified drugs |
705 |
688 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
492 |
469 |
$15K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
14 |
$12K |
| A4267 |
Contraceptive supply, condom, male, each |
945 |
925 |
$11K |
| 81025 |
|
1,860 |
1,741 |
$5K |
| 87806 |
|
143 |
143 |
$4K |
| S0190 |
Mifepristone, oral, 200 mg |
36 |
36 |
$2K |
| 90674 |
|
42 |
42 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
18 |
18 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
20 |
19 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
64 |
$1K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
334 |
319 |
$1K |
| 83986 |
|
343 |
328 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
152 |
149 |
$756.54 |
| 99000 |
|
140 |
139 |
$508.20 |
| S5000 |
Prescription drug, generic |
77 |
77 |
$273.73 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
14 |
14 |
$178.08 |
| 81002 |
|
75 |
72 |
$154.23 |
| S0191 |
Misoprostol, oral, 200 mcg |
35 |
35 |
$141.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
24 |
24 |
$131.52 |