| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
35,512 |
34,748 |
$2.54M |
| 87491 |
|
91,662 |
87,686 |
$2.40M |
| 87591 |
|
91,526 |
87,718 |
$2.18M |
| J3490 |
Drugs unclassified injection |
51,482 |
44,952 |
$1.23M |
| 99214 |
|
10,054 |
9,939 |
$1.03M |
| S4993 |
Contraceptive pills for bc |
7,955 |
7,838 |
$858K |
| 87806 |
|
43,654 |
38,771 |
$810K |
| 99212 |
|
13,027 |
12,772 |
$762K |
| 87661 |
|
31,320 |
31,242 |
$635K |
| 99203 |
|
3,178 |
3,158 |
$631K |
| 99211 |
|
15,555 |
15,389 |
$578K |
| 99202 |
|
4,353 |
4,330 |
$501K |
| J7307 |
Etonogestrel implant system |
385 |
383 |
$223K |
| 81025 |
|
45,656 |
44,949 |
$183K |
| A4267 |
Male condom |
32,066 |
31,653 |
$135K |
| Q3014 |
Telehealth facility fee |
7,805 |
7,559 |
$132K |
| 99201 |
|
1,326 |
1,310 |
$120K |
| 99000 |
|
31,774 |
31,613 |
$113K |
| S5199 |
Personal care item nos each |
12,160 |
12,077 |
$82K |
| S0199 |
Med abortion inc all ex drug |
228 |
228 |
$81K |
| 59840 |
|
643 |
335 |
$70K |
| 99204 |
|
295 |
295 |
$66K |
| 11981 |
|
388 |
383 |
$64K |
| S5000 |
Prescription drug, generic |
6,676 |
6,294 |
$37K |
| S9445 |
Pt education noc individ |
2,638 |
2,638 |
$34K |
| 83986 |
|
14,190 |
13,174 |
$33K |
| 58300 |
|
518 |
271 |
$33K |
| 87210 |
|
9,392 |
9,241 |
$25K |
| 76817 |
|
411 |
406 |
$20K |
| 11976 |
|
426 |
215 |
$17K |
| Q0144 |
Azithromycin dihydrate, oral |
3,128 |
2,341 |
$17K |
| S5001 |
Prescription drug,brand name |
4,695 |
4,481 |
$14K |
| J7300 |
Intra copp contra (paragard) |
25 |
25 |
$12K |
| 90651 |
|
53 |
53 |
$11K |
| J7298 |
Mirena, 52 mg |
16 |
16 |
$9K |
| 81002 |
|
3,679 |
3,638 |
$6K |
| G8510 |
Scr dep neg, no plan reqd |
910 |
910 |
$6K |
| 85018 |
|
733 |
724 |
$4K |
| S0190 |
Mifepristone, oral, 200 mg |
84 |
83 |
$3K |
| 82120 |
|
1,219 |
1,207 |
$3K |
| J8499 |
Oral prescrip drug non chemo |
1,889 |
1,610 |
$3K |
| 57454 |
|
48 |
26 |
$3K |
| J7303 |
Contraceptive vaginal ring |
12 |
12 |
$2K |
| 58301 |
|
81 |
41 |
$2K |
| 99152 |
|
75 |
75 |
$2K |
| 87624 |
|
70 |
70 |
$2K |
| 99215 |
Prolong outpt/office vis |
28 |
28 |
$1K |
| 96372 |
|
67 |
64 |
$850.09 |
| Q0111 |
Wet mounts/ w preparations |
232 |
230 |
$843.82 |
| 11982 |
|
23 |
12 |
$723.91 |
| 76815 |
|
13 |
13 |
$654.92 |
| 0012A |
|
15 |
15 |
$600.00 |
| J0696 |
Ceftriaxone sodium injection |
124 |
85 |
$519.74 |
| S0191 |
Misoprostol, oral, 200 mcg |
220 |
219 |
$470.51 |
| 36415 |
|
519 |
516 |
$392.75 |
| 90756 |
|
21 |
20 |
$298.48 |
| 86901 |
|
103 |
103 |
$290.24 |
| G8431 |
Pos clin depres scrn f/u doc |
12 |
12 |
$178.08 |
| 96127 |
|
36 |
36 |
$152.97 |
| 99406 |
|
14 |
14 |
$96.73 |
| J3010 |
Fentanyl citrate injection |
12 |
12 |
$50.32 |
| 86592 |
|
14 |
14 |
$21.40 |
| A4268 |
Female condom |
14 |
14 |
$0.00 |