| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
13,601 |
12,614 |
$1.10M |
| J7307 |
Etonogestrel implant system |
868 |
861 |
$878K |
| 99214 |
|
4,185 |
3,942 |
$383K |
| 99212 |
|
5,764 |
5,529 |
$373K |
| 99202 |
|
2,418 |
2,394 |
$356K |
| S4993 |
Contraceptive pills for bc |
2,818 |
2,798 |
$350K |
| J3490 |
Drugs unclassified injection |
8,988 |
7,402 |
$345K |
| 99203 |
|
1,444 |
1,435 |
$318K |
| J7304 |
Contraceptive hormone patch |
260 |
257 |
$226K |
| 87806 |
|
7,766 |
6,320 |
$206K |
| 11981 |
|
845 |
838 |
$200K |
| 58300 |
|
1,045 |
535 |
$107K |
| 99211 |
|
3,205 |
3,061 |
$84K |
| 99201 |
|
848 |
843 |
$84K |
| S0199 |
Med abortion inc all ex drug |
144 |
144 |
$76K |
| 99401 |
|
2,720 |
2,613 |
$52K |
| 87661 |
|
1,650 |
1,621 |
$51K |
| A4267 |
Male condom |
3,570 |
3,522 |
$33K |
| J7298 |
Mirena, 52 mg |
40 |
40 |
$31K |
| 90651 |
|
117 |
117 |
$30K |
| 11976 |
|
471 |
245 |
$28K |
| 76815 |
|
337 |
328 |
$24K |
| 81025 |
|
7,540 |
7,338 |
$23K |
| 99402 |
|
617 |
611 |
$19K |
| Q0111 |
Wet mounts/ w preparations |
4,219 |
4,082 |
$19K |
| S9445 |
Pt education noc individ |
1,324 |
1,324 |
$17K |
| 58301 |
|
514 |
269 |
$16K |
| 83986 |
|
5,094 |
4,491 |
$16K |
| 99000 |
|
4,400 |
4,325 |
$15K |
| S5000 |
Prescription drug, generic |
2,063 |
1,921 |
$14K |
| J7303 |
Contraceptive vaginal ring |
37 |
37 |
$11K |
| 99204 |
|
46 |
46 |
$11K |
| S0190 |
Mifepristone, oral, 200 mg |
160 |
160 |
$10K |
| J7300 |
Intra copp contra (paragard) |
13 |
13 |
$9K |
| 99070 |
|
2,307 |
1,620 |
$6K |
| 90686 |
|
222 |
221 |
$6K |
| Q3014 |
Telehealth facility fee |
191 |
190 |
$4K |
| 59840 |
|
24 |
12 |
$4K |
| 81002 |
|
1,539 |
1,481 |
$3K |
| G2012 |
Brief check in by md/qhp |
190 |
182 |
$2K |
| 99395 |
|
74 |
74 |
$1K |
| 87491 |
|
31 |
30 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
231 |
229 |
$904.93 |
| 11982 |
|
19 |
14 |
$866.76 |
| T1014 |
Telehealth transmit, per min |
189 |
188 |
$580.80 |
| 90471 |
|
240 |
233 |
$538.10 |
| Q0144 |
Azithromycin dihydrate, oral |
87 |
79 |
$246.08 |
| 85018 |
|
139 |
135 |
$245.78 |
| 87220 |
|
46 |
44 |
$143.73 |