| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,163 |
4,929 |
$703K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,451 |
6,140 |
$579K |
| J3490 |
Unclassified drugs |
10,709 |
9,364 |
$355K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,795 |
4,635 |
$308K |
| 87806 |
|
11,203 |
9,802 |
$289K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
5,802 |
5,432 |
$275K |
| S4993 |
Contraceptive pills for birth control |
1,609 |
1,584 |
$182K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,256 |
1,231 |
$162K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
751 |
713 |
$152K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
284 |
281 |
$71K |
| 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 |
146 |
144 |
$69K |
| A4267 |
Contraceptive supply, condom, male, each |
7,021 |
6,954 |
$49K |
| 81025 |
|
12,039 |
11,797 |
$36K |
| 99000 |
|
7,597 |
7,433 |
$29K |
| S5000 |
Prescription drug, generic |
5,041 |
4,478 |
$27K |
| 83986 |
|
7,477 |
6,626 |
$23K |
| 99201 |
|
210 |
210 |
$22K |
| 82120 |
|
3,690 |
3,581 |
$15K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
3,408 |
3,345 |
$13K |
| J7304 |
Contraceptive supply, hormone containing patch, each |
26 |
26 |
$13K |
| S5199 |
Personal care item, nos, each |
6,707 |
6,624 |
$13K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
14 |
$12K |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
882 |
882 |
$11K |
| 87210 |
|
2,084 |
2,042 |
$8K |
| 11976 |
|
111 |
54 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,222 |
1,080 |
$7K |
| S0190 |
Mifepristone, oral, 200 mg |
111 |
109 |
$7K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
41 |
37 |
$4K |
| 11981 |
|
14 |
14 |
$3K |
| 81002 |
|
1,021 |
990 |
$2K |
| 99401 |
|
42 |
41 |
$791.87 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
128 |
121 |
$646.19 |
| S0191 |
Misoprostol, oral, 200 mcg |
130 |
124 |
$380.36 |
| 90791 |
Psychiatric diagnostic evaluation |
90 |
88 |
$0.00 |