| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
6,427 |
6,404 |
$1.95M |
| S0190 |
Mifepristone, oral, 200 mg |
6,244 |
6,222 |
$265K |
| S0191 |
Misoprostol, oral, 200 mcg |
6,289 |
6,266 |
$103K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
474 |
473 |
$83K |
| Z1034 |
|
1,152 |
1,080 |
$64K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
397 |
397 |
$18K |
| Z1032 |
|
85 |
85 |
$17K |
| J2790 |
Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.) |
360 |
359 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
225 |
211 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
574 |
536 |
$14K |
| 81025 |
|
2,171 |
2,045 |
$12K |
| 99201 |
|
155 |
154 |
$9K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
206 |
204 |
$6K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
384 |
384 |
$4K |
| 76830 |
Ultrasound, transvaginal |
119 |
113 |
$3K |
| H1000 |
Prenatal care, at-risk assessment |
41 |
40 |
$3K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
26 |
26 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
61 |
59 |
$610.93 |
| 59425 |
|
45 |
29 |
$0.00 |