| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
22,222 |
20,134 |
$1.23M |
| J7307 |
Etonogestrel implant system |
919 |
854 |
$701K |
| 87491 |
|
22,869 |
17,348 |
$563K |
| 87591 |
|
22,869 |
17,357 |
$563K |
| S4993 |
Contraceptive pills for bc |
6,425 |
5,728 |
$348K |
| J1050 |
Medroxyprogesterone acetate |
4,187 |
3,813 |
$91K |
| J7298 |
Mirena, 52 mg |
151 |
143 |
$75K |
| J7297 |
Liletta, 52 mg |
361 |
320 |
$60K |
| 99202 |
|
1,145 |
1,056 |
$56K |
| 87661 |
|
2,103 |
1,777 |
$53K |
| 99203 |
|
817 |
756 |
$45K |
| 99214 |
|
502 |
471 |
$39K |
| 81025 |
|
4,486 |
4,212 |
$31K |
| 86703 |
|
1,243 |
1,172 |
$17K |
| 99212 |
|
264 |
255 |
$13K |
| S0199 |
Med abortion inc all ex drug |
26 |
25 |
$13K |
| 59840 |
|
66 |
53 |
$8K |
| 76817 |
|
103 |
91 |
$6K |
| J7303 |
Contraceptive vaginal ring |
143 |
104 |
$5K |
| 96372 |
|
344 |
322 |
$4K |
| S0190 |
Mifepristone, oral, 200 mg |
42 |
38 |
$3K |
| 87210 |
|
658 |
622 |
$3K |
| 96127 |
|
756 |
573 |
$2K |
| 99000 |
|
9,364 |
8,338 |
$2K |
| 83986 |
|
462 |
431 |
$1K |
| 36415 |
|
360 |
336 |
$1K |
| 58300 |
|
24 |
24 |
$995.04 |
| 85018 |
|
265 |
245 |
$705.20 |
| 86901 |
|
209 |
187 |
$674.33 |
| 99406 |
|
51 |
49 |
$522.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
77 |
69 |
$338.64 |
| Q0144 |
Azithromycin dihydrate, oral |
34 |
28 |
$223.20 |
| A4550 |
Surgical trays |
276 |
269 |
$111.42 |
| 87529 |
|
28 |
14 |
$98.04 |
| J8499 |
Oral prescrip drug non chemo |
78 |
73 |
$34.00 |
| 88300 |
|
40 |
39 |
$0.00 |
| 90674 |
|
12 |
12 |
$0.00 |
| OCINC |
|
13 |
13 |
$0.00 |