| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
9,760 |
9,515 |
$1.05M |
| 87491 |
|
23,428 |
21,282 |
$657K |
| 87591 |
|
23,372 |
21,293 |
$625K |
| J3490 |
Drugs unclassified injection |
23,389 |
19,365 |
$594K |
| S4993 |
Contraceptive pills for bc |
4,054 |
4,010 |
$525K |
| 99214 |
|
1,966 |
1,948 |
$311K |
| 99211 |
|
4,974 |
4,927 |
$293K |
| 99202 |
|
1,623 |
1,620 |
$292K |
| 87806 |
|
11,824 |
9,562 |
$261K |
| 99203 |
|
864 |
862 |
$236K |
| 99212 |
|
1,307 |
1,295 |
$120K |
| 99201 |
|
728 |
725 |
$87K |
| 87661 |
|
2,936 |
2,931 |
$85K |
| A4267 |
Male condom |
15,877 |
15,742 |
$66K |
| J7307 |
Etonogestrel implant system |
95 |
94 |
$65K |
| S9445 |
Pt education noc individ |
2,794 |
2,794 |
$36K |
| 81025 |
|
11,104 |
10,917 |
$33K |
| S5199 |
Personal care item nos each |
3,726 |
3,715 |
$31K |
| 99000 |
|
6,775 |
6,746 |
$23K |
| Q3014 |
Telehealth facility fee |
1,119 |
1,083 |
$22K |
| 11981 |
|
106 |
106 |
$19K |
| S5000 |
Prescription drug, generic |
2,065 |
1,951 |
$17K |
| J7298 |
Mirena, 52 mg |
14 |
14 |
$9K |
| 83986 |
|
3,346 |
3,022 |
$9K |
| Q0144 |
Azithromycin dihydrate, oral |
1,315 |
807 |
$8K |
| 58300 |
|
92 |
46 |
$8K |
| 99204 |
|
24 |
24 |
$7K |
| S5001 |
Prescription drug,brand name |
1,500 |
1,453 |
$5K |
| 87210 |
|
1,809 |
1,789 |
$5K |
| 11976 |
|
54 |
27 |
$3K |
| J7303 |
Contraceptive vaginal ring |
12 |
12 |
$3K |
| 81002 |
|
570 |
563 |
$1K |
| J8499 |
Oral prescrip drug non chemo |
104 |
86 |
$307.77 |
| Q0111 |
Wet mounts/ w preparations |
56 |
55 |
$204.96 |
| J0696 |
Ceftriaxone sodium injection |
24 |
12 |
$122.97 |
| 36415 |
|
25 |
25 |
$0.00 |