| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
5,349 |
5,101 |
$757K |
| 99213 |
|
7,855 |
7,397 |
$738K |
| J3490 |
Drugs unclassified injection |
17,989 |
15,270 |
$555K |
| S4993 |
Contraceptive pills for bc |
4,318 |
4,272 |
$515K |
| 87806 |
|
17,609 |
15,193 |
$456K |
| 99202 |
|
3,153 |
3,042 |
$438K |
| S0199 |
Med abortion inc all ex drug |
868 |
864 |
$432K |
| 99203 |
|
1,511 |
1,460 |
$346K |
| 99211 |
|
7,027 |
6,477 |
$334K |
| 99212 |
|
4,796 |
4,638 |
$319K |
| J7307 |
Etonogestrel implant system |
346 |
340 |
$309K |
| 99204 |
|
1,109 |
1,098 |
$270K |
| 11981 |
|
362 |
356 |
$82K |
| A4267 |
Male condom |
9,791 |
9,699 |
$73K |
| 58300 |
|
708 |
359 |
$69K |
| S0190 |
Mifepristone, oral, 200 mg |
911 |
907 |
$60K |
| 90651 |
|
248 |
245 |
$55K |
| 99201 |
|
525 |
525 |
$52K |
| 99000 |
|
11,401 |
11,195 |
$44K |
| 81025 |
|
12,712 |
12,401 |
$41K |
| S9445 |
Pt education noc individ |
2,693 |
2,693 |
$34K |
| 59840 |
|
178 |
89 |
$29K |
| S5000 |
Prescription drug, generic |
4,830 |
4,350 |
$29K |
| 76817 |
|
280 |
271 |
$24K |
| S5199 |
Personal care item nos each |
8,395 |
8,313 |
$21K |
| 11976 |
|
336 |
166 |
$21K |
| 83986 |
|
5,921 |
5,162 |
$18K |
| J7304 |
Contraceptive hormone patch |
24 |
24 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
2,667 |
2,590 |
$10K |
| 82120 |
|
1,997 |
1,945 |
$8K |
| J7298 |
Mirena, 52 mg |
12 |
12 |
$8K |
| J7303 |
Contraceptive vaginal ring |
54 |
54 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral |
815 |
726 |
$5K |
| 87210 |
|
1,235 |
1,219 |
$4K |
| 58301 |
|
136 |
70 |
$4K |
| S0191 |
Misoprostol, oral, 200 mcg |
899 |
884 |
$3K |
| 99401 |
|
146 |
141 |
$3K |
| 81002 |
|
923 |
898 |
$2K |
| J7295 |
Eth estr and eton monthly |
12 |
12 |
$2K |
| 76815 |
|
12 |
12 |
$725.01 |
| 99152 |
|
12 |
12 |
$601.92 |
| 64435 |
|
12 |
12 |
$483.12 |
| J0696 |
Ceftriaxone sodium injection |
83 |
81 |
$423.81 |
| 85018 |
|
98 |
98 |
$198.04 |
| J3010 |
Fentanyl citrate injection |
25 |
25 |
$127.66 |
| J2250 |
Inj midazolam hydrochloride |
25 |
25 |
$117.03 |