| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0520 |
|
20,215 |
9,219 |
$2.72M |
| 0514 |
|
1,603 |
883 |
$447K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,542 |
3,488 |
$445K |
| J3490 |
Unclassified drugs |
7,382 |
6,259 |
$439K |
| S4993 |
Contraceptive pills for birth control |
3,732 |
3,696 |
$381K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,746 |
2,704 |
$266K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,215 |
1,202 |
$259K |
| 0510 |
|
466 |
449 |
$206K |
| 87806 |
|
7,915 |
6,276 |
$202K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
927 |
923 |
$163K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,930 |
1,925 |
$127K |
| 99201 |
|
748 |
745 |
$96K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
43 |
41 |
$76K |
| 0300 |
|
6,824 |
4,537 |
$48K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
3,035 |
3,035 |
$39K |
| A4267 |
Contraceptive supply, condom, male, each |
3,406 |
3,403 |
$31K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
115 |
$30K |
| S5000 |
Prescription drug, generic |
1,992 |
1,858 |
$20K |
| 0270 |
|
1,749 |
1,458 |
$18K |
| 81025 |
|
4,919 |
4,867 |
$15K |
| 99402 |
|
431 |
431 |
$14K |
| 58300 |
|
100 |
51 |
$13K |
| 86703 |
|
1,197 |
976 |
$13K |
| 86780 |
|
1,089 |
1,086 |
$11K |
| S0190 |
Mifepristone, oral, 200 mg |
179 |
172 |
$11K |
| J7303 |
Contraceptive supply, hormone containing vaginal ring, each |
16 |
16 |
$10K |
| 0320 |
|
107 |
101 |
$9K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
219 |
211 |
$7K |
| 83986 |
|
2,620 |
2,112 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
190 |
183 |
$7K |
| 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 |
| 11981 |
|
24 |
18 |
$5K |
| 87808 |
|
418 |
405 |
$4K |
| 99000 |
|
1,022 |
1,021 |
$4K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
846 |
838 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
111 |
109 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
398 |
288 |
$2K |
| 86803 |
|
30 |
30 |
$420.77 |
| S0191 |
Misoprostol, oral, 200 mcg |
280 |
264 |
$221.85 |
| A4649 |
Surgical supply; miscellaneous |
13 |
13 |
$214.00 |
| 81002 |
|
94 |
93 |
$173.81 |
| 85018 |
|
66 |
63 |
$145.17 |