| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
10,865 |
10,105 |
$1.72M |
| 99213 |
|
16,524 |
15,558 |
$1.70M |
| S4993 |
Contraceptive pills for bc |
6,692 |
6,517 |
$753K |
| 87806 |
|
25,663 |
20,762 |
$633K |
| 99203 |
|
2,114 |
2,078 |
$557K |
| J3490 |
Drugs unclassified injection |
10,783 |
9,294 |
$508K |
| 99212 |
|
6,349 |
6,090 |
$493K |
| J7307 |
Etonogestrel implant system |
483 |
455 |
$407K |
| 99202 |
|
1,766 |
1,652 |
$280K |
| 99201 |
|
1,972 |
1,835 |
$202K |
| 99211 |
|
3,376 |
3,331 |
$195K |
| S0199 |
Med abortion inc all ex drug |
269 |
268 |
$136K |
| 87491 |
|
2,963 |
2,938 |
$119K |
| 87591 |
|
2,964 |
2,939 |
$96K |
| 11981 |
|
426 |
426 |
$92K |
| A4267 |
Male condom |
7,868 |
7,791 |
$72K |
| 81025 |
|
18,060 |
17,672 |
$59K |
| 99000 |
|
13,356 |
12,960 |
$48K |
| 87661 |
|
2,252 |
2,236 |
$44K |
| S9445 |
Pt education noc individ |
2,601 |
2,601 |
$33K |
| S5000 |
Prescription drug, generic |
3,185 |
3,034 |
$21K |
| S0190 |
Mifepristone, oral, 200 mg |
335 |
332 |
$21K |
| J7304 |
Contraceptive hormone patch |
41 |
39 |
$20K |
| 83986 |
|
6,045 |
5,288 |
$17K |
| 87210 |
|
3,975 |
3,896 |
$13K |
| 11976 |
|
131 |
131 |
$12K |
| 58300 |
|
120 |
67 |
$12K |
| 86701 |
|
1,535 |
1,116 |
$10K |
| J7303 |
Contraceptive vaginal ring |
54 |
54 |
$8K |
| 76817 |
|
282 |
273 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral |
1,315 |
824 |
$7K |
| S5199 |
Personal care item nos each |
1,250 |
1,232 |
$6K |
| 96372 |
|
148 |
145 |
$4K |
| 90651 |
|
13 |
13 |
$3K |
| 81002 |
|
1,443 |
1,414 |
$3K |
| 99204 |
|
19 |
19 |
$3K |
| 58301 |
|
65 |
39 |
$2K |
| S0191 |
Misoprostol, oral, 200 mcg |
357 |
349 |
$1K |
| 87529 |
|
27 |
27 |
$778.16 |
| 85018 |
|
367 |
354 |
$432.39 |
| 36415 |
|
297 |
262 |
$53.47 |