| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
1,318 |
1,284 |
$1.07M |
| S4993 |
Contraceptive pills for birth control |
4,222 |
4,177 |
$728K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14,523 |
14,344 |
$590K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
14,488 |
14,313 |
$577K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,247 |
8,328 |
$519K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,124 |
13,747 |
$511K |
| 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 |
417 |
414 |
$233K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,301 |
3,214 |
$227K |
| 90651 |
|
832 |
816 |
$175K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,047 |
1,883 |
$161K |
| J3490 |
Unclassified drugs |
5,254 |
5,044 |
$135K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
119 |
118 |
$122K |
| A4267 |
Contraceptive supply, condom, male, each |
10,243 |
9,917 |
$117K |
| 11981 |
|
553 |
523 |
$102K |
| 87806 |
|
4,216 |
4,166 |
$95K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,860 |
2,488 |
$75K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,089 |
918 |
$69K |
| 58300 |
|
557 |
255 |
$51K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
629 |
521 |
$49K |
| 90674 |
|
1,612 |
1,591 |
$48K |
| 81025 |
|
16,474 |
15,513 |
$45K |
| Q3014 |
Telehealth originating site facility fee |
2,534 |
2,368 |
$42K |
| 11976 |
|
702 |
323 |
$40K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,865 |
1,820 |
$39K |
| 96156 |
|
608 |
604 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
314 |
305 |
$35K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
35 |
29 |
$20K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
472 |
352 |
$20K |
| S0190 |
Mifepristone, oral, 200 mg |
437 |
377 |
$19K |
| 90715 |
|
396 |
393 |
$18K |
| 99385 |
|
340 |
326 |
$17K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
3,408 |
3,306 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
649 |
641 |
$13K |
| 83986 |
|
3,410 |
3,308 |
$11K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
12 |
12 |
$9K |
| 99000 |
|
3,336 |
3,193 |
$8K |
| 58301 |
|
222 |
108 |
$6K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
31 |
31 |
$6K |
| 96150 |
|
615 |
615 |
$6K |
| 57454 |
|
56 |
28 |
$4K |
| 81002 |
|
1,945 |
1,870 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,215 |
2,163 |
$2K |
| 59425 |
|
28 |
25 |
$2K |
| 96151 |
|
248 |
247 |
$2K |
| 86580 |
|
154 |
153 |
$1K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
254 |
239 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
218 |
214 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
438 |
378 |
$885.62 |
| 85018 |
|
619 |
603 |
$790.50 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
428 |
427 |
$629.21 |
| 87430 |
|
50 |
50 |
$529.13 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
32 |
32 |
$454.14 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
216 |
216 |
$441.67 |
| 96127 |
|
155 |
155 |
$422.72 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
301 |
299 |
$349.16 |
| 86901 |
|
26 |
26 |
$48.98 |
| S5000 |
Prescription drug, generic |
2,349 |
1,951 |
$26.08 |
| S5001 |
Prescription drug, brand name |
362 |
362 |
$2.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
796 |
795 |
$0.78 |
| 1160F |
|
2,393 |
2,389 |
$0.00 |
| 1159F |
|
2,393 |
2,389 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
719 |
715 |
$0.00 |
| 3078F |
|
1,879 |
1,875 |
$0.00 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
1,598 |
1,565 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
117 |
117 |
$0.00 |
| 4004F |
|
72 |
72 |
$0.00 |
| 99442 |
|
40 |
33 |
$0.00 |
| 1036F |
|
2,062 |
2,058 |
$0.00 |
| 3074F |
|
1,946 |
1,942 |
$0.00 |
| 2000F |
|
815 |
814 |
$0.00 |
| 3008F |
|
403 |
403 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
442 |
442 |
$0.00 |
| 99441 |
|
12 |
12 |
$0.00 |