| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
7,015 |
6,809 |
$682K |
| J3490 |
Drugs unclassified injection |
15,682 |
12,891 |
$571K |
| J7307 |
Etonogestrel implant system |
536 |
527 |
$498K |
| S4993 |
Contraceptive pills for bc |
4,316 |
4,237 |
$484K |
| S0199 |
Med abortion inc all ex drug |
1,020 |
1,008 |
$429K |
| 99214 |
|
2,208 |
2,173 |
$361K |
| 99202 |
|
2,409 |
2,398 |
$324K |
| 99203 |
|
1,285 |
1,282 |
$284K |
| 58300 |
|
1,537 |
775 |
$162K |
| 87806 |
|
7,029 |
6,030 |
$153K |
| 11981 |
|
526 |
518 |
$124K |
| J7298 |
Mirena, 52 mg |
156 |
156 |
$118K |
| 99211 |
|
5,611 |
5,336 |
$110K |
| 99204 |
|
333 |
332 |
$97K |
| 99212 |
|
1,627 |
1,588 |
$91K |
| 99201 |
|
998 |
985 |
$88K |
| A4267 |
Male condom |
7,015 |
6,891 |
$63K |
| 87661 |
|
2,747 |
2,733 |
$63K |
| S0190 |
Mifepristone, oral, 200 mg |
982 |
964 |
$48K |
| J7304 |
Contraceptive hormone patch |
56 |
55 |
$45K |
| 99401 |
|
2,231 |
2,217 |
$43K |
| 87491 |
|
4,144 |
4,118 |
$37K |
| J7300 |
Intra copp contra (paragard) |
51 |
51 |
$37K |
| 87591 |
|
4,158 |
4,131 |
$36K |
| S9445 |
Pt education noc individ |
2,669 |
2,669 |
$34K |
| 58301 |
|
1,018 |
520 |
$31K |
| 99402 |
|
858 |
853 |
$27K |
| 76815 |
|
741 |
711 |
$27K |
| J7303 |
Contraceptive vaginal ring |
83 |
82 |
$24K |
| 81025 |
|
7,075 |
6,943 |
$24K |
| 11976 |
|
293 |
156 |
$20K |
| S5000 |
Prescription drug, generic |
2,398 |
2,244 |
$20K |
| 99000 |
|
5,039 |
4,935 |
$14K |
| 99403 |
|
292 |
291 |
$13K |
| 83986 |
|
4,738 |
4,082 |
$13K |
| Q0111 |
Wet mounts/ w preparations |
3,535 |
3,446 |
$12K |
| S0191 |
Misoprostol, oral, 200 mcg |
1,064 |
1,017 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
668 |
596 |
$2K |
| 85018 |
|
623 |
599 |
$2K |
| 11982 |
|
30 |
14 |
$2K |
| 81002 |
|
926 |
903 |
$2K |
| G2012 |
Brief check in by md/qhp |
124 |
123 |
$1K |
| J8499 |
Oral prescrip drug non chemo |
67 |
38 |
$505.85 |
| J4390 |
|
23 |
12 |
$320.75 |
| 86901 |
|
81 |
74 |
$142.78 |
| 0250 |
|
124 |
117 |
$0.00 |