| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
5,175 |
4,908 |
$363K |
| J7307 |
Etonogestrel implant system |
381 |
375 |
$298K |
| 99214 |
|
3,199 |
3,114 |
$278K |
| 99202 |
|
1,943 |
1,934 |
$262K |
| 99212 |
|
3,772 |
3,643 |
$244K |
| 99203 |
|
1,015 |
1,014 |
$201K |
| S4993 |
Contraceptive pills for bc |
1,439 |
1,425 |
$146K |
| 99204 |
|
643 |
640 |
$146K |
| S0199 |
Med abortion inc all ex drug |
291 |
290 |
$104K |
| J3490 |
Drugs unclassified injection |
2,838 |
2,534 |
$88K |
| 87806 |
|
4,240 |
3,950 |
$87K |
| 90651 |
|
347 |
347 |
$73K |
| 87661 |
|
2,552 |
2,530 |
$67K |
| 11981 |
|
366 |
360 |
$63K |
| 99211 |
|
1,451 |
1,405 |
$53K |
| 58300 |
|
388 |
193 |
$32K |
| J7304 |
Contraceptive hormone patch |
17 |
16 |
$18K |
| 11976 |
|
286 |
149 |
$18K |
| S5000 |
Prescription drug, generic |
1,945 |
1,852 |
$16K |
| 81025 |
|
5,546 |
5,349 |
$13K |
| S0190 |
Mifepristone, oral, 200 mg |
270 |
269 |
$10K |
| J7300 |
Intra copp contra (paragard) |
15 |
15 |
$10K |
| 99000 |
|
3,334 |
3,259 |
$9K |
| Q0111 |
Wet mounts/ w preparations |
2,971 |
2,867 |
$9K |
| A4267 |
Male condom |
830 |
820 |
$7K |
| 83986 |
|
3,190 |
2,898 |
$7K |
| S9445 |
Pt education noc individ |
502 |
502 |
$6K |
| 58301 |
|
221 |
113 |
$6K |
| 99401 |
|
163 |
161 |
$3K |
| 81002 |
|
1,131 |
1,071 |
$2K |
| 99070 |
|
518 |
345 |
$1K |
| 90471 |
|
245 |
244 |
$790.49 |
| S0191 |
Misoprostol, oral, 200 mcg |
299 |
288 |
$626.23 |
| J8499 |
Oral prescrip drug non chemo |
68 |
44 |
$535.57 |
| 76815 |
|
13 |
13 |
$426.81 |
| 87491 |
|
936 |
896 |
$153.90 |
| 87591 |
|
936 |
896 |
$153.37 |
| J0696 |
Ceftriaxone sodium injection |
27 |
27 |
$129.52 |
| 85018 |
|
60 |
56 |
$77.03 |
| 90686 |
|
19 |
19 |
$9.92 |
| 90656 |
|
29 |
28 |
$0.00 |
| 3079F |
|
180 |
177 |
$0.00 |
| 3074F |
|
487 |
485 |
$0.00 |
| 3075F |
|
31 |
30 |
$0.00 |
| Q3014 |
Telehealth facility fee |
23 |
22 |
$0.00 |
| T1014 |
Telehealth transmit, per min |
23 |
22 |
$0.00 |
| 3078F |
|
454 |
451 |
$0.00 |