| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
8,977 |
8,399 |
$897K |
| 99214 |
|
5,302 |
4,840 |
$850K |
| 99212 |
|
4,393 |
4,111 |
$316K |
| 87806 |
|
12,600 |
10,275 |
$309K |
| S4993 |
Contraceptive pills for bc |
2,321 |
2,306 |
$290K |
| 99203 |
|
1,188 |
1,144 |
$283K |
| J3490 |
Drugs unclassified injection |
5,337 |
4,443 |
$235K |
| 99202 |
|
1,196 |
1,072 |
$186K |
| J7307 |
Etonogestrel implant system |
183 |
177 |
$145K |
| 99211 |
|
1,078 |
1,064 |
$61K |
| 99201 |
|
365 |
319 |
$35K |
| S0199 |
Med abortion inc all ex drug |
67 |
67 |
$33K |
| A4267 |
Male condom |
3,388 |
3,189 |
$31K |
| 11981 |
|
162 |
162 |
$31K |
| J1050 |
Medroxyprogesterone acetate |
362 |
353 |
$30K |
| 58300 |
|
316 |
171 |
$29K |
| 81025 |
|
9,076 |
8,939 |
$28K |
| 99000 |
|
6,856 |
6,686 |
$23K |
| S9445 |
Pt education noc individ |
1,071 |
1,071 |
$14K |
| S5000 |
Prescription drug, generic |
1,863 |
1,743 |
$12K |
| 76817 |
|
332 |
311 |
$12K |
| 11976 |
|
89 |
89 |
$8K |
| 83986 |
|
3,035 |
2,704 |
$8K |
| 87210 |
|
2,119 |
2,082 |
$7K |
| J7303 |
Contraceptive vaginal ring |
41 |
41 |
$7K |
| J7304 |
Contraceptive hormone patch |
16 |
16 |
$6K |
| 58301 |
|
203 |
110 |
$5K |
| S5199 |
Personal care item nos each |
1,458 |
1,454 |
$5K |
| S0190 |
Mifepristone, oral, 200 mg |
80 |
76 |
$5K |
| 86701 |
|
516 |
394 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
486 |
290 |
$3K |
| 81002 |
|
529 |
514 |
$959.11 |
| 99152 |
|
12 |
12 |
$554.16 |
| 85018 |
|
339 |
325 |
$364.47 |
| 96372 |
|
15 |
15 |
$289.96 |
| S0191 |
Misoprostol, oral, 200 mcg |
98 |
90 |
$288.20 |
| 36415 |
|
606 |
574 |
$1.50 |