| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
9,127 |
8,675 |
$610K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,299 |
5,621 |
$562K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,564 |
1,420 |
$221K |
| J3490 |
Unclassified drugs |
8,026 |
6,985 |
$220K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,317 |
1,270 |
$168K |
| S4993 |
Contraceptive pills for birth control |
2,212 |
2,182 |
$160K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
65 |
65 |
$57K |
| 99201 |
|
515 |
493 |
$53K |
| 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 |
87 |
87 |
$38K |
| 81025 |
|
12,236 |
11,583 |
$35K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
144 |
133 |
$30K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
293 |
290 |
$25K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
274 |
263 |
$22K |
| 58300 |
|
212 |
106 |
$20K |
| A4267 |
Contraceptive supply, condom, male, each |
5,301 |
5,243 |
$15K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,023 |
1,023 |
$13K |
| 11981 |
|
53 |
53 |
$12K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,158 |
1,019 |
$10K |
| S0190 |
Mifepristone, oral, 200 mg |
113 |
113 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
206 |
195 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
211 |
209 |
$5K |
| 83986 |
|
1,612 |
1,385 |
$5K |
| 87210 |
|
1,115 |
1,097 |
$4K |
| 99401 |
|
139 |
137 |
$3K |
| 11976 |
|
50 |
25 |
$2K |
| 58301 |
|
60 |
30 |
$2K |
| 81005 |
|
665 |
635 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
128 |
123 |
$598.23 |
| J7295 |
Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each |
13 |
13 |
$565.41 |
| 85018 |
|
232 |
220 |
$456.55 |
| T1014 |
Telehealth transmission, per minute, professional services bill separately |
210 |
208 |
$305.88 |
| S0191 |
Misoprostol, oral, 200 mcg |
126 |
126 |
$240.89 |
| 81002 |
|
90 |
88 |
$186.55 |