| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
8,210 |
7,521 |
$1.00M |
| 99214 |
|
4,628 |
4,422 |
$907K |
| 99203 |
|
2,520 |
2,428 |
$772K |
| S4993 |
Contraceptive pills for bc |
6,268 |
6,250 |
$643K |
| J3490 |
Drugs unclassified injection |
18,572 |
15,803 |
$581K |
| 99211 |
|
9,453 |
8,268 |
$570K |
| 99212 |
|
5,672 |
5,450 |
$522K |
| 99202 |
|
1,713 |
1,674 |
$323K |
| 87806 |
|
10,553 |
8,096 |
$260K |
| 99204 |
|
623 |
622 |
$244K |
| J7307 |
Etonogestrel implant system |
228 |
228 |
$214K |
| 99201 |
|
1,139 |
978 |
$138K |
| 58300 |
|
919 |
462 |
$90K |
| A4267 |
Male condom |
11,391 |
11,256 |
$90K |
| 11981 |
|
233 |
232 |
$56K |
| S9445 |
Pt education noc individ |
4,002 |
4,002 |
$51K |
| 81025 |
|
14,189 |
13,757 |
$46K |
| J7303 |
Contraceptive vaginal ring |
477 |
477 |
$42K |
| S5000 |
Prescription drug, generic |
6,117 |
5,761 |
$42K |
| J7300 |
Intra copp contra (paragard) |
51 |
51 |
$42K |
| 83986 |
|
11,385 |
9,367 |
$30K |
| 99401 |
|
1,516 |
1,507 |
$29K |
| 99000 |
|
7,731 |
7,673 |
$27K |
| J7304 |
Contraceptive hormone patch |
89 |
89 |
$27K |
| Q0111 |
Wet mounts/ w preparations |
6,893 |
6,664 |
$25K |
| 11976 |
|
322 |
162 |
$18K |
| 86703 |
|
1,255 |
1,007 |
$14K |
| 58301 |
|
427 |
220 |
$13K |
| 87491 |
|
450 |
434 |
$7K |
| 87591 |
|
451 |
434 |
$7K |
| S0199 |
Med abortion inc all ex drug |
12 |
12 |
$6K |
| 81002 |
|
2,470 |
2,404 |
$5K |
| Q0144 |
Azithromycin dihydrate, oral |
1,171 |
1,149 |
$4K |
| 82120 |
|
971 |
935 |
$3K |
| 87210 |
|
949 |
925 |
$3K |
| 99402 |
|
83 |
83 |
$3K |
| J7295 |
Eth estr and eton monthly |
12 |
12 |
$2K |
| 86592 |
|
625 |
624 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
221 |
201 |
$1K |
| 87389 |
|
53 |
53 |
$688.44 |
| 36416 |
|
33 |
33 |
$0.00 |