| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
3,759 |
3,727 |
$2.08M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
38,065 |
33,881 |
$1.14M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
36,262 |
33,315 |
$1.10M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,737 |
14,091 |
$1.02M |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
2,180 |
2,156 |
$883K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
1,295 |
1,273 |
$604K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
10,197 |
9,852 |
$478K |
| 58300 |
|
4,349 |
4,218 |
$446K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
9,061 |
9,002 |
$441K |
| 11981 |
|
3,224 |
3,192 |
$431K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
5,667 |
5,599 |
$411K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,911 |
3,785 |
$401K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,544 |
3,498 |
$381K |
| 11982 |
|
2,285 |
2,263 |
$277K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
8,022 |
7,584 |
$240K |
| 99152 |
|
3,613 |
3,600 |
$223K |
| 58301 |
|
2,100 |
2,020 |
$199K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
10,249 |
10,035 |
$187K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
2,596 |
2,343 |
$168K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,593 |
1,556 |
$156K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
920 |
909 |
$148K |
| 87481 |
|
5,054 |
4,775 |
$147K |
| 81025 |
|
18,891 |
18,227 |
$136K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
2,202 |
2,092 |
$136K |
| J7296 |
Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg |
237 |
232 |
$124K |
| 90651 |
|
654 |
626 |
$120K |
| 86703 |
|
8,956 |
8,565 |
$101K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
3,336 |
3,294 |
$98K |
| J7298 |
Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg |
152 |
148 |
$90K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
995 |
888 |
$75K |
| 87480 |
|
3,206 |
3,122 |
$64K |
| 87510 |
|
3,206 |
3,122 |
$63K |
| 99201 |
|
1,079 |
1,078 |
$43K |
| 87660 |
|
1,987 |
1,953 |
$37K |
| 86901 |
|
8,173 |
8,130 |
$31K |
| S4993 |
Contraceptive pills for birth control |
436 |
431 |
$29K |
| J2788 |
Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) |
582 |
579 |
$22K |
| 85018 |
|
6,562 |
6,451 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
840 |
806 |
$16K |
| 81513 |
|
224 |
222 |
$11K |
| 96127 |
|
1,686 |
1,661 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
8,832 |
8,570 |
$11K |
| J3490 |
Unclassified drugs |
558 |
550 |
$10K |
| 11983 |
|
53 |
53 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
403 |
403 |
$9K |
| 81002 |
|
1,985 |
1,885 |
$5K |
| 59200 |
|
38 |
37 |
$3K |
| 99000 |
|
11,907 |
11,575 |
$3K |
| 90739 |
|
12 |
12 |
$1K |
| 59841 |
|
12 |
12 |
$867.90 |
| 87529 |
|
26 |
12 |
$648.88 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
422 |
410 |
$636.73 |
| 87806 |
|
14 |
14 |
$455.21 |
| 99459 |
|
17 |
16 |
$288.93 |
| 87210 |
|
17 |
17 |
$77.86 |