| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel implant system |
3,268 |
3,077 |
$3.17M |
| S0199 |
Med abortion inc all ex drug |
4,640 |
4,569 |
$2.34M |
| J7298 |
Mirena, 52 mg |
1,559 |
1,419 |
$1.44M |
| 99212 |
|
21,940 |
20,530 |
$1.15M |
| 87491 |
|
22,791 |
22,582 |
$731K |
| 87591 |
|
22,745 |
22,538 |
$727K |
| 58300 |
|
7,330 |
3,664 |
$672K |
| J7296 |
Kyleena, 19.5 mg |
634 |
634 |
$638K |
| J3490 |
Drugs unclassified injection |
17,799 |
16,244 |
$621K |
| 11981 |
|
2,609 |
2,553 |
$554K |
| 59840 |
|
2,909 |
1,580 |
$524K |
| S4993 |
Contraceptive pills for bc |
3,211 |
3,203 |
$510K |
| 90651 |
|
1,530 |
1,525 |
$411K |
| A4267 |
Male condom |
24,818 |
24,695 |
$370K |
| S0190 |
Mifepristone, oral, 200 mg |
5,036 |
5,006 |
$323K |
| 99213 |
|
5,880 |
5,793 |
$317K |
| J7300 |
Intra copp contra (paragard) |
323 |
285 |
$262K |
| 99202 |
|
3,393 |
3,384 |
$255K |
| 87806 |
|
8,752 |
8,733 |
$238K |
| J7304 |
Contraceptive hormone patch |
96 |
95 |
$233K |
| 11976 |
|
3,813 |
1,936 |
$211K |
| J7301 |
Skyla, 13.5 mg |
286 |
166 |
$211K |
| 76817 |
|
2,427 |
2,352 |
$200K |
| 87661 |
|
5,905 |
5,851 |
$194K |
| 87799 |
|
3,546 |
3,526 |
$144K |
| 58301 |
|
4,530 |
2,286 |
$130K |
| 87481 |
|
3,559 |
3,539 |
$119K |
| 01966 |
|
1,147 |
1,134 |
$79K |
| 81025 |
|
22,336 |
21,485 |
$67K |
| 99203 |
|
408 |
407 |
$59K |
| 87563 |
|
1,338 |
1,333 |
$51K |
| Q0144 |
Azithromycin dihydrate, oral |
5,171 |
4,894 |
$43K |
| 99201 |
|
700 |
699 |
$34K |
| 99000 |
|
2,905 |
2,892 |
$33K |
| G9920 |
Scrning perf and negative |
4,645 |
4,622 |
$32K |
| 76830 |
|
393 |
391 |
$27K |
| 99211 |
|
812 |
785 |
$22K |
| S0191 |
Misoprostol, oral, 200 mcg |
5,036 |
5,007 |
$16K |
| 11982 |
|
205 |
117 |
$14K |
| 76815 |
|
158 |
158 |
$12K |
| 57454 |
|
196 |
99 |
$11K |
| S9445 |
Pt education noc individ |
853 |
853 |
$11K |
| 99214 |
|
81 |
81 |
$8K |
| G2012 |
Brief check in by md/qhp |
380 |
371 |
$5K |
| 81002 |
|
1,742 |
1,709 |
$4K |
| 85018 |
|
1,792 |
1,765 |
$4K |
| T1014 |
Telehealth transmit, per min |
1,802 |
1,736 |
$4K |
| 83986 |
|
1,034 |
994 |
$3K |
| Q0111 |
Wet mounts/ w preparations |
799 |
795 |
$3K |
| 87210 |
|
554 |
542 |
$2K |
| 76998 |
|
15 |
15 |
$2K |
| 86901 |
|
626 |
623 |
$2K |
| 99152 |
|
26 |
26 |
$1K |
| G9919 |
Scrn nd pos nd prov of rec |
161 |
161 |
$258.97 |
| J0696 |
Ceftriaxone sodium injection |
31 |
31 |
$18.13 |