| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
4,600 |
4,259 |
$701K |
| 99213 |
|
4,484 |
4,175 |
$464K |
| S4993 |
Contraceptive pills for bc |
2,333 |
2,299 |
$240K |
| 87806 |
|
10,478 |
8,615 |
$239K |
| J3490 |
Drugs unclassified injection |
8,140 |
7,111 |
$231K |
| 99211 |
|
3,895 |
3,379 |
$217K |
| 99203 |
|
886 |
798 |
$209K |
| 99204 |
|
523 |
523 |
$137K |
| 99212 |
|
1,839 |
1,795 |
$134K |
| 99202 |
|
895 |
854 |
$129K |
| 99201 |
|
222 |
222 |
$25K |
| 81025 |
|
8,287 |
8,089 |
$22K |
| S5000 |
Prescription drug, generic |
3,388 |
3,092 |
$19K |
| 99000 |
|
5,150 |
5,102 |
$19K |
| S9445 |
Pt education noc individ |
1,369 |
1,369 |
$17K |
| 83986 |
|
6,299 |
5,277 |
$17K |
| A4267 |
Male condom |
2,024 |
2,011 |
$12K |
| Q0111 |
Wet mounts/ w preparations |
3,052 |
2,965 |
$10K |
| S0199 |
Med abortion inc all ex drug |
30 |
30 |
$10K |
| J7307 |
Etonogestrel implant system |
12 |
12 |
$9K |
| 11981 |
|
24 |
24 |
$5K |
| 82120 |
|
1,353 |
1,283 |
$4K |
| 81002 |
|
1,181 |
1,154 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
351 |
293 |
$2K |
| 87210 |
|
742 |
715 |
$2K |
| 58300 |
|
26 |
13 |
$2K |
| S5199 |
Personal care item nos each |
494 |
489 |
$714.77 |
| S0191 |
Misoprostol, oral, 200 mcg |
42 |
42 |
$109.50 |