| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel implant system |
959 |
935 |
$782K |
| S4993 |
Contraceptive pills for bc |
3,680 |
3,621 |
$678K |
| 99214 |
|
8,116 |
7,280 |
$427K |
| 87491 |
|
9,734 |
9,636 |
$390K |
| 87591 |
|
9,704 |
9,609 |
$380K |
| 99213 |
|
10,977 |
9,428 |
$354K |
| J1050 |
Medroxyprogesterone acetate |
2,909 |
2,825 |
$203K |
| J7304 |
Contraceptive hormone patch |
175 |
163 |
$145K |
| J3490 |
Drugs unclassified injection |
5,516 |
5,308 |
$137K |
| 90651 |
|
606 |
596 |
$123K |
| 99395 |
|
1,181 |
1,096 |
$98K |
| A4267 |
Male condom |
7,218 |
7,035 |
$83K |
| 99212 |
|
2,744 |
2,513 |
$71K |
| 87806 |
|
2,986 |
2,968 |
$61K |
| S0199 |
Med abortion inc all ex drug |
103 |
103 |
$60K |
| 99203 |
|
727 |
619 |
$43K |
| 90674 |
|
1,284 |
1,271 |
$37K |
| 81025 |
|
11,336 |
10,906 |
$34K |
| 96156 |
|
368 |
364 |
$23K |
| 99385 |
|
499 |
471 |
$23K |
| Q3014 |
Telehealth facility fee |
1,252 |
1,186 |
$23K |
| 11976 |
|
337 |
159 |
$17K |
| 11981 |
|
76 |
69 |
$15K |
| Q0144 |
Azithromycin dihydrate, oral |
1,006 |
986 |
$15K |
| 99211 |
|
650 |
629 |
$11K |
| Q0111 |
Wet mounts/ w preparations |
2,523 |
2,481 |
$10K |
| 99204 |
|
86 |
84 |
$9K |
| 83986 |
|
2,524 |
2,482 |
$8K |
| 99000 |
|
2,199 |
2,154 |
$6K |
| 90715 |
|
118 |
118 |
$5K |
| S0190 |
Mifepristone, oral, 200 mg |
62 |
62 |
$4K |
| 99202 |
|
69 |
59 |
$3K |
| 96150 |
|
226 |
225 |
$3K |
| 81002 |
|
1,440 |
1,401 |
$3K |
| 90471 |
|
1,535 |
1,496 |
$2K |
| 86580 |
|
191 |
183 |
$2K |
| 96127 |
|
452 |
418 |
$2K |
| 58300 |
|
24 |
12 |
$1K |
| 90707 |
|
12 |
12 |
$960.00 |
| 83036 |
|
525 |
519 |
$928.63 |
| 58301 |
|
24 |
12 |
$868.66 |
| G2012 |
Brief check in by md/qhp |
61 |
60 |
$830.42 |
| J0696 |
Ceftriaxone sodium injection |
142 |
141 |
$761.36 |
| G0442 |
Annual alcohol screen 15 min |
74 |
74 |
$472.13 |
| 93000 |
|
19 |
19 |
$453.17 |
| G8431 |
Pos clin depres scrn f/u doc |
360 |
359 |
$240.51 |
| S0191 |
Misoprostol, oral, 200 mcg |
62 |
62 |
$212.46 |
| 85018 |
|
327 |
320 |
$206.82 |
| 87430 |
|
12 |
12 |
$167.30 |
| S5000 |
Prescription drug, generic |
2,169 |
1,845 |
$11.79 |
| G8510 |
Scr dep neg, no plan reqd |
672 |
671 |
$0.93 |
| 1159F |
|
1,433 |
1,433 |
$0.00 |
| G8783 |
Bp scrn perf rec interval |
1,117 |
1,078 |
$0.00 |
| 3078F |
|
1,111 |
1,111 |
$0.00 |
| S5001 |
Prescription drug,brand name |
174 |
172 |
$0.00 |
| 1160F |
|
1,434 |
1,434 |
$0.00 |
| G8417 |
Calc bmi abv up param f/u |
405 |
405 |
$0.00 |
| G0444 |
Depression screen annual |
14 |
14 |
$0.00 |
| 4004F |
|
12 |
12 |
$0.00 |
| 1036F |
|
1,136 |
1,136 |
$0.00 |
| 3074F |
|
1,122 |
1,122 |
$0.00 |
| G8420 |
Calc bmi norm parameters |
266 |
266 |
$0.00 |
| 3008F |
|
405 |
405 |
$0.00 |
| 2000F |
|
512 |
509 |
$0.00 |