| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,686 |
2,468 |
$429K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,945 |
2,765 |
$310K |
| 87806 |
|
8,620 |
7,254 |
$222K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
746 |
679 |
$201K |
| J3490 |
Unclassified drugs |
5,481 |
4,824 |
$170K |
| S4993 |
Contraceptive pills for birth control |
1,429 |
1,421 |
$169K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,795 |
1,740 |
$130K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,377 |
2,226 |
$123K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
491 |
485 |
$72K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
215 |
208 |
$62K |
| 59840 |
|
161 |
81 |
$30K |
| 58300 |
|
318 |
166 |
$30K |
| 99201 |
|
267 |
267 |
$29K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,669 |
1,669 |
$21K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
26 |
26 |
$21K |
| A4267 |
Contraceptive supply, condom, male, each |
2,807 |
2,774 |
$20K |
| 99000 |
|
4,808 |
4,701 |
$18K |
| 81025 |
|
5,769 |
5,621 |
$17K |
| S5000 |
Prescription drug, generic |
2,188 |
2,020 |
$12K |
| J7300 |
Intrauterine copper contraceptive (paragard) |
16 |
16 |
$11K |
| 83986 |
|
3,096 |
2,639 |
$9K |
| 90651 |
|
36 |
36 |
$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 |
13 |
12 |
$7K |
| 11981 |
|
26 |
26 |
$6K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,482 |
1,452 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
78 |
77 |
$5K |
| 99401 |
|
241 |
237 |
$5K |
| S5199 |
Personal care item, nos, each |
1,132 |
1,127 |
$3K |
| 82120 |
|
501 |
471 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
305 |
271 |
$2K |
| 11976 |
|
24 |
12 |
$1K |
| 99152 |
|
25 |
25 |
$1K |
| 64435 |
|
27 |
27 |
$1K |
| 81002 |
|
445 |
435 |
$885.80 |
| S0190 |
Mifepristone, oral, 200 mg |
13 |
12 |
$834.91 |
| 87210 |
|
204 |
188 |
$747.29 |
| 85018 |
|
85 |
84 |
$175.08 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
26 |
26 |
$134.84 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
26 |
26 |
$115.87 |
| S0191 |
Misoprostol, oral, 200 mcg |
13 |
12 |
$38.60 |