| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00940 |
|
2,149 |
2,032 |
$102K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,338 |
1,249 |
$96K |
| S5001 |
Prescription drug, brand name |
1,447 |
1,327 |
$65K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
776 |
739 |
$61K |
| 81025 |
|
3,657 |
3,431 |
$28K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
515 |
488 |
$8K |
| 85018 |
|
2,507 |
2,354 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
84 |
81 |
$6K |
| 86901 |
|
1,422 |
1,338 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
155 |
145 |
$5K |
| 76857 |
|
45 |
42 |
$3K |
| 85013 |
|
770 |
738 |
$2K |
| S4993 |
Contraceptive pills for birth control |
16 |
16 |
$945.00 |
| 87210 |
|
40 |
40 |
$226.40 |
| 81002 |
|
52 |
52 |
$176.28 |
| S0190 |
Mifepristone, oral, 200 mg |
19 |
19 |
$0.00 |
| 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 |
19 |
19 |
$0.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
19 |
19 |
$0.00 |
| 36416 |
|
2,483 |
2,333 |
$0.00 |
| 88300 |
|
247 |
234 |
$0.00 |