| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
7,998 |
7,622 |
$1.01M |
| 99213 |
|
8,100 |
7,796 |
$682K |
| J3490 |
Drugs unclassified injection |
19,370 |
16,774 |
$653K |
| 99211 |
|
8,830 |
8,212 |
$379K |
| S4993 |
Contraceptive pills for bc |
3,275 |
3,224 |
$363K |
| 87806 |
|
14,974 |
12,875 |
$361K |
| 99212 |
|
4,892 |
4,794 |
$277K |
| 99203 |
|
1,183 |
1,167 |
$239K |
| 99202 |
|
1,841 |
1,760 |
$230K |
| S0199 |
Med abortion inc all ex drug |
397 |
393 |
$194K |
| J7307 |
Etonogestrel implant system |
160 |
160 |
$131K |
| 99204 |
|
617 |
617 |
$128K |
| J7304 |
Contraceptive hormone patch |
93 |
93 |
$66K |
| A4267 |
Male condom |
7,776 |
7,735 |
$63K |
| 99201 |
|
584 |
580 |
$53K |
| 81025 |
|
17,660 |
17,382 |
$50K |
| 99000 |
|
9,321 |
9,197 |
$37K |
| 11981 |
|
158 |
158 |
$35K |
| S5000 |
Prescription drug, generic |
7,081 |
5,967 |
$26K |
| 83986 |
|
8,177 |
7,328 |
$23K |
| 11976 |
|
369 |
184 |
$19K |
| S0190 |
Mifepristone, oral, 200 mg |
326 |
325 |
$19K |
| S5199 |
Personal care item nos each |
5,612 |
5,581 |
$17K |
| S9445 |
Pt education noc individ |
1,284 |
1,284 |
$16K |
| 82120 |
|
3,736 |
3,681 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
3,627 |
3,587 |
$13K |
| 90791 |
|
72 |
63 |
$12K |
| 76817 |
|
124 |
118 |
$9K |
| Q0144 |
Azithromycin dihydrate, oral |
1,529 |
1,347 |
$9K |
| 87210 |
|
1,914 |
1,904 |
$6K |
| J7303 |
Contraceptive vaginal ring |
24 |
24 |
$3K |
| 90651 |
|
13 |
13 |
$3K |
| 81002 |
|
1,415 |
1,395 |
$3K |
| 99401 |
|
138 |
138 |
$3K |
| 58300 |
|
26 |
13 |
$2K |
| 58301 |
|
79 |
40 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
281 |
262 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
409 |
392 |
$1K |
| G2012 |
Brief check in by md/qhp |
18 |
18 |
$228.78 |