| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
969 |
915 |
$115K |
| J3490 |
Unclassified drugs |
3,497 |
2,959 |
$111K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,157 |
1,084 |
$93K |
| 87806 |
|
3,294 |
2,987 |
$86K |
| S4993 |
Contraceptive pills for birth control |
429 |
426 |
$54K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
872 |
835 |
$51K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,087 |
1,042 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
75 |
73 |
$16K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
70 |
69 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
109 |
103 |
$14K |
| A4267 |
Contraceptive supply, condom, male, each |
1,557 |
1,528 |
$14K |
| 99000 |
|
2,498 |
2,404 |
$10K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
12 |
12 |
$10K |
| 99201 |
|
119 |
119 |
$9K |
| 81025 |
|
2,662 |
2,590 |
$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 |
$6K |
| S5199 |
Personal care item, nos, each |
1,543 |
1,511 |
$5K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
239 |
239 |
$3K |
| 11981 |
|
12 |
12 |
$3K |
| 83986 |
|
666 |
609 |
$2K |
| S5000 |
Prescription drug, generic |
379 |
333 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
12 |
$1K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
281 |
268 |
$1K |
| 82120 |
|
253 |
239 |
$1K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
115 |
101 |
$693.13 |
| 87210 |
|
133 |
129 |
$477.79 |