| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,349 |
5,101 |
$757K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,855 |
7,397 |
$738K |
| J3490 |
Unclassified drugs |
17,989 |
15,270 |
$555K |
| S4993 |
Contraceptive pills for birth control |
4,318 |
4,272 |
$515K |
| 87806 |
|
17,609 |
15,193 |
$456K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
3,153 |
3,042 |
$438K |
| 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 |
868 |
864 |
$432K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,511 |
1,460 |
$346K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
7,027 |
6,477 |
$334K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,796 |
4,638 |
$319K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
346 |
340 |
$309K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,109 |
1,098 |
$270K |
| 11981 |
|
362 |
356 |
$82K |
| A4267 |
Contraceptive supply, condom, male, each |
9,791 |
9,699 |
$73K |
| 58300 |
|
708 |
359 |
$69K |
| S0190 |
Mifepristone, oral, 200 mg |
911 |
907 |
$60K |
| 90651 |
|
248 |
245 |
$55K |
| 99201 |
|
525 |
525 |
$52K |
| 99000 |
|
11,401 |
11,195 |
$44K |
| 81025 |
|
12,712 |
12,401 |
$41K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
2,693 |
2,693 |
$34K |
| 59840 |
|
178 |
89 |
$29K |
| S5000 |
Prescription drug, generic |
4,830 |
4,350 |
$29K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
280 |
271 |
$24K |
| S5199 |
Personal care item, nos, each |
8,395 |
8,313 |
$21K |
| 11976 |
|
336 |
166 |
$21K |
| 83986 |
|
5,921 |
5,162 |
$18K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
24 |
24 |
$14K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
2,667 |
2,590 |
$10K |
| 82120 |
|
1,997 |
1,945 |
$8K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
12 |
12 |
$8K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
54 |
54 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
815 |
726 |
$5K |
| 87210 |
|
1,235 |
1,219 |
$4K |
| 58301 |
|
136 |
70 |
$4K |
| S0191 |
Misoprostol, oral, 200 mcg |
899 |
884 |
$3K |
| 99401 |
|
146 |
141 |
$3K |
| 81002 |
|
923 |
898 |
$2K |
| J7295 |
Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each |
12 |
12 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$725.01 |
| 99152 |
|
12 |
12 |
$601.92 |
| 64435 |
|
12 |
12 |
$483.12 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
83 |
81 |
$423.81 |
| 85018 |
|
98 |
98 |
$198.04 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
25 |
25 |
$127.66 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
25 |
25 |
$117.03 |