| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel implant system |
998 |
991 |
$792K |
| 99213 |
|
8,314 |
8,038 |
$652K |
| 99214 |
|
4,916 |
4,772 |
$572K |
| S0199 |
Med abortion inc all ex drug |
1,494 |
1,482 |
$487K |
| 99202 |
|
3,187 |
3,166 |
$395K |
| J3490 |
Drugs unclassified injection |
10,947 |
9,021 |
$375K |
| 87806 |
|
14,113 |
11,982 |
$290K |
| S4993 |
Contraceptive pills for bc |
2,403 |
2,382 |
$283K |
| 99212 |
|
4,891 |
4,735 |
$272K |
| 99203 |
|
1,203 |
1,203 |
$254K |
| J7304 |
Contraceptive hormone patch |
237 |
236 |
$199K |
| 11981 |
|
932 |
924 |
$192K |
| 99211 |
|
7,931 |
7,444 |
$182K |
| 59840 |
|
1,228 |
636 |
$152K |
| 87661 |
|
4,870 |
4,835 |
$115K |
| 76815 |
|
2,616 |
2,501 |
$109K |
| 58300 |
|
1,091 |
555 |
$100K |
| 99204 |
|
349 |
349 |
$85K |
| S0190 |
Mifepristone, oral, 200 mg |
1,161 |
1,159 |
$63K |
| J7298 |
Mirena, 52 mg |
91 |
90 |
$62K |
| 99401 |
|
3,204 |
3,032 |
$61K |
| 11976 |
|
760 |
392 |
$46K |
| A4267 |
Male condom |
4,733 |
4,669 |
$39K |
| 99000 |
|
9,674 |
9,501 |
$34K |
| 99201 |
|
414 |
411 |
$33K |
| S5000 |
Prescription drug, generic |
4,014 |
3,637 |
$32K |
| 58301 |
|
859 |
451 |
$26K |
| 81025 |
|
9,930 |
9,668 |
$24K |
| 83986 |
|
8,607 |
7,394 |
$21K |
| Q0111 |
Wet mounts/ w preparations |
6,856 |
6,641 |
$20K |
| 99070 |
|
3,072 |
1,515 |
$17K |
| 11982 |
|
250 |
143 |
$14K |
| S9445 |
Pt education noc individ |
694 |
694 |
$9K |
| 99402 |
|
249 |
248 |
$8K |
| S0191 |
Misoprostol, oral, 200 mcg |
1,729 |
1,697 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
527 |
511 |
$4K |
| Q3014 |
Telehealth facility fee |
232 |
229 |
$4K |
| G2012 |
Brief check in by md/qhp |
294 |
289 |
$3K |
| 81002 |
|
1,691 |
1,653 |
$3K |
| 85018 |
|
1,583 |
1,500 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
480 |
437 |
$2K |
| J3010 |
Fentanyl citrate injection |
264 |
256 |
$726.03 |
| 86901 |
|
398 |
375 |
$632.40 |
| J8499 |
Oral prescrip drug non chemo |
45 |
24 |
$478.24 |
| 87491 |
|
14 |
13 |
$335.73 |
| 87591 |
|
14 |
13 |
$314.44 |
| J2250 |
Inj midazolam hydrochloride |
286 |
279 |
$261.58 |
| 76817 |
|
15 |
15 |
$246.51 |
| T1014 |
Telehealth transmit, per min |
233 |
230 |
$173.51 |
| 99152 |
|
13 |
12 |
$144.61 |