| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
|
15,118 |
14,461 |
$1.19M |
| 99213 |
|
10,280 |
9,693 |
$1.05M |
| 99211 |
|
20,985 |
20,047 |
$966K |
| J7307 |
Etonogestrel implant system |
1,096 |
1,096 |
$946K |
| J3490 |
Drugs unclassified injection |
33,218 |
28,948 |
$935K |
| 99202 |
|
3,883 |
3,879 |
$705K |
| 99203 |
|
1,897 |
1,854 |
$600K |
| 99214 |
|
3,275 |
3,150 |
$526K |
| 87491 |
|
23,760 |
23,282 |
$506K |
| S4993 |
Contraceptive pills for bc |
7,751 |
7,681 |
$496K |
| 87806 |
|
17,460 |
14,817 |
$379K |
| 11981 |
|
1,124 |
1,124 |
$300K |
| J7304 |
Contraceptive hormone patch |
834 |
823 |
$275K |
| 87591 |
|
23,737 |
23,244 |
$266K |
| S0199 |
Med abortion inc all ex drug |
545 |
540 |
$227K |
| 99201 |
|
2,151 |
2,094 |
$166K |
| A4267 |
Male condom |
26,364 |
25,594 |
$134K |
| 99204 |
|
329 |
329 |
$129K |
| 81025 |
|
32,467 |
30,991 |
$120K |
| 55250 |
|
808 |
405 |
$120K |
| 58300 |
|
759 |
393 |
$89K |
| 99401 |
|
3,931 |
3,873 |
$75K |
| 11976 |
|
910 |
461 |
$57K |
| S9445 |
Pt education noc individ |
4,115 |
4,115 |
$52K |
| 99000 |
|
13,952 |
13,810 |
$39K |
| S5000 |
Prescription drug, generic |
5,734 |
5,341 |
$38K |
| 83986 |
|
10,649 |
9,272 |
$26K |
| 86703 |
|
2,744 |
2,542 |
$23K |
| S0190 |
Mifepristone, oral, 200 mg |
482 |
480 |
$17K |
| Q0111 |
Wet mounts/ w preparations |
4,409 |
4,295 |
$16K |
| Q0144 |
Azithromycin dihydrate, oral |
3,327 |
3,208 |
$15K |
| 86592 |
|
6,336 |
6,297 |
$13K |
| J7303 |
Contraceptive vaginal ring |
168 |
168 |
$12K |
| 99402 |
|
284 |
284 |
$9K |
| 82120 |
|
3,770 |
3,675 |
$9K |
| 76817 |
|
226 |
216 |
$9K |
| 87210 |
|
3,782 |
3,688 |
$7K |
| 87389 |
|
600 |
598 |
$5K |
| 81002 |
|
2,577 |
2,512 |
$5K |
| J0561 |
Penicillin g benzathine inj |
192 |
145 |
$4K |
| 58301 |
|
128 |
66 |
$4K |
| 85018 |
|
1,186 |
1,164 |
$4K |
| 11982 |
|
62 |
32 |
$3K |
| J0696 |
Ceftriaxone sodium injection |
495 |
416 |
$3K |
| 59840 |
|
24 |
12 |
$2K |
| J7295 |
Eth estr and eton monthly |
14 |
14 |
$2K |
| 88175 |
|
137 |
137 |
$1K |
| 86901 |
|
1,056 |
909 |
$1K |
| 36416 |
|
138 |
135 |
$987.44 |
| 99403 |
|
18 |
18 |
$800.75 |
| S0191 |
Misoprostol, oral, 200 mcg |
534 |
532 |
$760.54 |
| J3010 |
Fentanyl citrate injection |
37 |
37 |
$104.31 |
| 87086 |
|
45 |
45 |
$79.55 |
| J7030 |
Normal saline solution infus |
13 |
13 |
$52.00 |
| 36415 |
|
96 |
89 |
$0.00 |