| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
|
8,493 |
7,627 |
$537K |
| J7298 |
Mirena, 52 mg |
318 |
269 |
$261K |
| J3490 |
Drugs unclassified injection |
4,055 |
3,700 |
$216K |
| 99202 |
|
590 |
581 |
$83K |
| A4267 |
Male condom |
4,648 |
4,626 |
$82K |
| 58300 |
|
766 |
382 |
$65K |
| 87806 |
|
2,507 |
2,480 |
$50K |
| J7307 |
Etonogestrel implant system |
52 |
49 |
$36K |
| S0199 |
Med abortion inc all ex drug |
71 |
71 |
$29K |
| S4993 |
Contraceptive pills for bc |
189 |
189 |
$28K |
| 99211 |
|
402 |
343 |
$23K |
| 81025 |
|
6,101 |
5,763 |
$21K |
| 99000 |
|
2,395 |
2,390 |
$13K |
| 87491 |
|
107 |
106 |
$5K |
| 90651 |
|
19 |
19 |
$5K |
| 58301 |
|
150 |
76 |
$4K |
| 99201 |
|
41 |
24 |
$4K |
| S9445 |
Pt education noc individ |
264 |
264 |
$3K |
| 76830 |
|
58 |
58 |
$3K |
| S0190 |
Mifepristone, oral, 200 mg |
53 |
53 |
$3K |
| 11976 |
|
48 |
25 |
$2K |
| Q0111 |
Wet mounts/ w preparations |
553 |
544 |
$2K |
| 87591 |
|
108 |
107 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
133 |
101 |
$2K |
| 11981 |
|
13 |
13 |
$2K |
| G9920 |
Scrning perf and negative |
57 |
55 |
$1K |
| 83986 |
|
192 |
186 |
$564.92 |
| 99213 |
|
26 |
26 |
$443.72 |
| 86592 |
|
117 |
117 |
$353.56 |
| 81002 |
|
161 |
158 |
$252.88 |
| T1014 |
Telehealth transmit, per min |
151 |
151 |
$252.24 |
| S0191 |
Misoprostol, oral, 200 mcg |
72 |
72 |
$162.16 |