| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,515 |
8,107 |
$1.20M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,075 |
8,683 |
$870K |
| J3490 |
Unclassified drugs |
15,448 |
13,542 |
$518K |
| 87806 |
|
19,650 |
16,948 |
$469K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
6,843 |
6,319 |
$318K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,330 |
1,294 |
$316K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,234 |
4,170 |
$287K |
| S4993 |
Contraceptive pills for birth control |
2,478 |
2,447 |
$268K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
204 |
204 |
$165K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
290 |
286 |
$157K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
711 |
681 |
$108K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
380 |
380 |
$100K |
| 90651 |
|
357 |
355 |
$75K |
| 81025 |
|
17,125 |
16,934 |
$46K |
| 99000 |
|
11,823 |
11,731 |
$45K |
| 11981 |
|
204 |
204 |
$42K |
| A4267 |
Contraceptive supply, condom, male, each |
6,236 |
6,207 |
$41K |
| S5000 |
Prescription drug, generic |
6,953 |
6,195 |
$31K |
| 99201 |
|
276 |
276 |
$28K |
| 83986 |
|
9,719 |
8,705 |
$27K |
| 90837 |
Psychotherapy, 53 minutes with patient |
165 |
66 |
$20K |
| 11976 |
|
357 |
182 |
$19K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
4,796 |
4,722 |
$16K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,276 |
1,276 |
$16K |
| 59840 |
|
112 |
57 |
$15K |
| 58300 |
|
155 |
80 |
$12K |
| 57454 |
|
212 |
105 |
$12K |
| 82120 |
|
3,402 |
3,319 |
$12K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
12 |
12 |
$8K |
| 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 |
12 |
12 |
$7K |
| S5199 |
Personal care item, nos, each |
5,913 |
5,871 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
926 |
814 |
$5K |
| 87210 |
|
1,578 |
1,558 |
$5K |
| 58301 |
|
89 |
46 |
$2K |
| 81002 |
|
1,050 |
1,031 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
27 |
$2K |
| 57452 |
|
23 |
12 |
$736.15 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
119 |
106 |
$575.23 |
| 99401 |
|
26 |
26 |
$448.18 |
| 99152 |
|
16 |
16 |
$443.18 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
29 |
25 |
$263.14 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
33 |
25 |
$209.65 |
| 85018 |
|
55 |
55 |
$98.74 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
12 |
$0.00 |