| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
8,077 |
7,392 |
$1.23M |
| 99213 |
|
8,913 |
8,402 |
$933K |
| S4993 |
Contraceptive pills for bc |
4,390 |
4,222 |
$514K |
| 87806 |
|
17,205 |
13,738 |
$435K |
| 99212 |
|
5,946 |
5,391 |
$417K |
| J3490 |
Drugs unclassified injection |
6,714 |
5,764 |
$336K |
| 99203 |
|
970 |
943 |
$260K |
| 99202 |
|
980 |
872 |
$158K |
| S0199 |
Med abortion inc all ex drug |
167 |
167 |
$93K |
| J7307 |
Etonogestrel implant system |
104 |
98 |
$86K |
| 99201 |
|
955 |
871 |
$83K |
| 99211 |
|
1,562 |
1,539 |
$82K |
| 81025 |
|
13,247 |
12,935 |
$44K |
| A4267 |
Male condom |
3,424 |
3,375 |
$41K |
| 99000 |
|
8,335 |
8,082 |
$32K |
| 11981 |
|
111 |
111 |
$23K |
| 58300 |
|
246 |
134 |
$23K |
| S5000 |
Prescription drug, generic |
3,120 |
2,879 |
$20K |
| 83986 |
|
6,045 |
5,366 |
$17K |
| S9445 |
Pt education noc individ |
1,183 |
1,183 |
$15K |
| 87210 |
|
4,291 |
4,169 |
$14K |
| S0190 |
Mifepristone, oral, 200 mg |
181 |
181 |
$12K |
| S5199 |
Personal care item nos each |
1,182 |
1,166 |
$7K |
| 76817 |
|
234 |
223 |
$6K |
| 86701 |
|
661 |
545 |
$4K |
| J7303 |
Contraceptive vaginal ring |
41 |
41 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral |
710 |
446 |
$4K |
| 11976 |
|
41 |
41 |
$4K |
| 81002 |
|
1,662 |
1,623 |
$3K |
| 87591 |
|
59 |
59 |
$2K |
| 87491 |
|
59 |
59 |
$2K |
| 57454 |
|
26 |
14 |
$2K |
| 58301 |
|
57 |
30 |
$2K |
| 96372 |
|
44 |
44 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
204 |
204 |
$714.27 |
| 87661 |
|
14 |
14 |
$371.12 |
| 85018 |
|
251 |
243 |
$175.76 |
| J0696 |
Ceftriaxone sodium injection |
28 |
28 |
$103.73 |