| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
3,712 |
3,495 |
$328K |
| J3490 |
Drugs unclassified injection |
7,607 |
6,662 |
$284K |
| S4993 |
Contraceptive pills for bc |
2,146 |
2,120 |
$274K |
| 99214 |
|
1,990 |
1,898 |
$260K |
| 99202 |
|
2,002 |
1,933 |
$243K |
| J7307 |
Etonogestrel implant system |
277 |
275 |
$231K |
| 99203 |
|
1,058 |
1,038 |
$218K |
| 87806 |
|
7,271 |
6,696 |
$191K |
| 99211 |
|
4,010 |
3,628 |
$181K |
| S0199 |
Med abortion inc all ex drug |
330 |
328 |
$173K |
| 99212 |
|
2,508 |
2,414 |
$151K |
| 99204 |
|
531 |
527 |
$119K |
| 11981 |
|
287 |
286 |
$64K |
| A4267 |
Male condom |
4,378 |
4,339 |
$34K |
| 11976 |
|
456 |
229 |
$26K |
| 81025 |
|
7,481 |
7,314 |
$26K |
| 90651 |
|
106 |
105 |
$23K |
| S0190 |
Mifepristone, oral, 200 mg |
319 |
317 |
$20K |
| 99000 |
|
5,040 |
4,966 |
$19K |
| S9445 |
Pt education noc individ |
1,097 |
1,097 |
$14K |
| J7303 |
Contraceptive vaginal ring |
85 |
82 |
$13K |
| 58300 |
|
137 |
70 |
$12K |
| S5199 |
Personal care item nos each |
3,702 |
3,664 |
$12K |
| 99201 |
|
133 |
133 |
$12K |
| S5000 |
Prescription drug, generic |
1,753 |
1,556 |
$9K |
| J7298 |
Mirena, 52 mg |
13 |
13 |
$9K |
| 83986 |
|
1,718 |
1,636 |
$6K |
| 82120 |
|
919 |
883 |
$4K |
| Q0111 |
Wet mounts/ w preparations |
919 |
880 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
502 |
414 |
$3K |
| 58301 |
|
82 |
42 |
$2K |
| 99401 |
|
103 |
102 |
$2K |
| 87210 |
|
461 |
453 |
$2K |
| 99402 |
|
46 |
45 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
346 |
336 |
$1K |
| 81002 |
|
302 |
293 |
$627.21 |
| J0696 |
Ceftriaxone sodium injection |
76 |
75 |
$384.22 |
| 85018 |
|
54 |
54 |
$113.81 |