| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
9,595 |
9,062 |
$1.01M |
| 99214 |
|
6,376 |
5,874 |
$979K |
| 87806 |
|
14,916 |
11,981 |
$377K |
| 99203 |
|
1,313 |
1,241 |
$365K |
| 99212 |
|
4,228 |
3,893 |
$292K |
| J3490 |
Drugs unclassified injection |
5,950 |
5,154 |
$281K |
| S4993 |
Contraceptive pills for bc |
2,190 |
2,106 |
$240K |
| 99202 |
|
816 |
760 |
$133K |
| 99211 |
|
1,729 |
1,712 |
$95K |
| A4267 |
Male condom |
4,366 |
4,278 |
$48K |
| 81025 |
|
11,554 |
11,229 |
$36K |
| 99201 |
|
296 |
262 |
$32K |
| 99000 |
|
6,780 |
6,582 |
$26K |
| S0199 |
Med abortion inc all ex drug |
42 |
42 |
$23K |
| S5000 |
Prescription drug, generic |
2,445 |
2,281 |
$17K |
| 83986 |
|
4,769 |
4,173 |
$13K |
| S9445 |
Pt education noc individ |
979 |
979 |
$12K |
| 87210 |
|
3,098 |
3,038 |
$10K |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$10K |
| 11981 |
|
24 |
24 |
$5K |
| 86701 |
|
607 |
479 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral |
701 |
450 |
$4K |
| S5199 |
Personal care item nos each |
470 |
464 |
$3K |
| 81002 |
|
960 |
931 |
$2K |
| S0190 |
Mifepristone, oral, 200 mg |
28 |
28 |
$2K |
| 76817 |
|
57 |
56 |
$2K |
| 99401 |
|
44 |
44 |
$839.08 |
| 87491 |
|
20 |
20 |
$688.00 |
| 87591 |
|
20 |
20 |
$492.16 |
| S0191 |
Misoprostol, oral, 200 mcg |
27 |
27 |
$87.41 |
| 85018 |
|
97 |
95 |
$75.25 |