| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
130,095 |
111,876 |
$6.45M |
| 87491 |
|
171,934 |
146,719 |
$5.73M |
| 87591 |
|
171,821 |
146,698 |
$5.73M |
| 87661 |
|
146,929 |
135,571 |
$4.33M |
| S4993 |
Contraceptive pills for bc |
69,924 |
59,534 |
$3.44M |
| J1050 |
Medroxyprogesterone acetate |
44,961 |
38,335 |
$2.35M |
| 99214 |
|
25,318 |
21,990 |
$2.01M |
| 99212 |
|
31,182 |
27,611 |
$1.02M |
| 96372 |
|
59,808 |
50,060 |
$914K |
| A4267 |
Male condom |
67,947 |
62,729 |
$829K |
| 76815 |
|
11,490 |
9,466 |
$729K |
| 99202 |
|
14,816 |
13,526 |
$723K |
| 81025 |
|
72,264 |
63,329 |
$505K |
| 99395 |
|
6,198 |
5,852 |
$457K |
| 99156 |
|
11,531 |
9,243 |
$382K |
| 36415 |
|
96,472 |
84,109 |
$378K |
| 99203 |
|
4,265 |
3,466 |
$362K |
| S5001 |
Prescription drug,brand name |
11,068 |
10,160 |
$327K |
| 87210 |
|
48,329 |
41,944 |
$225K |
| S5000 |
Prescription drug, generic |
18,586 |
12,744 |
$196K |
| 85018 |
|
41,073 |
33,806 |
$102K |
| 76817 |
|
1,519 |
1,155 |
$98K |
| 87481 |
|
3,309 |
3,062 |
$96K |
| 59840 |
|
1,738 |
1,020 |
$89K |
| 81513 |
|
1,242 |
1,178 |
$83K |
| 96127 |
|
4,927 |
4,282 |
$73K |
| J7303 |
Contraceptive vaginal ring |
1,028 |
972 |
$67K |
| 86901 |
|
19,535 |
16,384 |
$62K |
| 99204 |
|
381 |
349 |
$55K |
| 87624 |
|
995 |
958 |
$29K |
| 87801 |
|
544 |
467 |
$28K |
| 99201 |
|
799 |
733 |
$22K |
| 58300 |
|
517 |
450 |
$21K |
| 81002 |
|
7,467 |
6,483 |
$21K |
| S0199 |
Med abortion inc all ex drug |
1,071 |
739 |
$18K |
| J7307 |
Etonogestrel implant system |
53 |
48 |
$18K |
| 99152 |
|
342 |
317 |
$17K |
| 01966 |
|
456 |
268 |
$14K |
| 90471 |
|
1,357 |
1,189 |
$12K |
| 99442 |
|
230 |
182 |
$9K |
| J7295 |
Eth estr and eton monthly |
438 |
419 |
$7K |
| 11982 |
|
73 |
64 |
$7K |
| S0190 |
Mifepristone, oral, 200 mg |
1,124 |
767 |
$5K |
| 90656 |
|
241 |
225 |
$4K |
| 99396 |
|
44 |
42 |
$4K |
| 90686 |
|
229 |
203 |
$4K |
| J7298 |
Mirena, 52 mg |
12 |
12 |
$4K |
| 90651 |
|
13 |
13 |
$3K |
| 90688 |
|
253 |
217 |
$2K |
| 99385 |
|
15 |
14 |
$2K |
| 58301 |
|
25 |
25 |
$2K |
| 99215 |
Prolong outpt/office vis |
16 |
13 |
$2K |
| 99211 |
|
116 |
105 |
$2K |
| 11981 |
|
12 |
12 |
$1K |
| 96160 |
|
730 |
594 |
$1K |
| 99000 |
|
16,510 |
11,378 |
$478.50 |
| S0191 |
Misoprostol, oral, 200 mcg |
1,521 |
881 |
$472.66 |
| 87625 |
|
15 |
14 |
$433.72 |
| 90756 |
|
13 |
13 |
$341.24 |
| 99408 |
|
12 |
12 |
$246.40 |
| 83986 |
|
11,868 |
10,658 |
$152.95 |
| 76998 |
|
265 |
179 |
$13.86 |
| J8499 |
Oral prescrip drug non chemo |
6,362 |
2,033 |
$7.50 |
| J0696 |
Ceftriaxone sodium injection |
13 |
12 |
$7.20 |