| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
7,356 |
7,119 |
$709K |
| 99214 |
|
3,614 |
3,546 |
$568K |
| 99202 |
|
3,880 |
3,865 |
$551K |
| J7307 |
Etonogestrel implant system |
536 |
534 |
$520K |
| J3490 |
Drugs unclassified injection |
13,646 |
11,000 |
$504K |
| S4993 |
Contraceptive pills for bc |
3,463 |
3,408 |
$403K |
| 99212 |
|
4,888 |
4,795 |
$367K |
| 99211 |
|
7,471 |
7,221 |
$255K |
| 87806 |
|
10,312 |
8,734 |
$228K |
| 99203 |
|
843 |
842 |
$212K |
| S0199 |
Med abortion inc all ex drug |
387 |
387 |
$182K |
| 99201 |
|
1,584 |
1,566 |
$127K |
| 11981 |
|
480 |
478 |
$118K |
| 58300 |
|
1,109 |
560 |
$103K |
| 87661 |
|
3,122 |
3,094 |
$86K |
| 99204 |
|
250 |
250 |
$76K |
| J7298 |
Mirena, 52 mg |
91 |
91 |
$71K |
| A4267 |
Male condom |
5,348 |
5,200 |
$53K |
| 76815 |
|
819 |
799 |
$35K |
| 99000 |
|
8,833 |
8,670 |
$31K |
| J7300 |
Intra copp contra (paragard) |
24 |
24 |
$27K |
| J7304 |
Contraceptive hormone patch |
29 |
29 |
$27K |
| 11976 |
|
379 |
199 |
$26K |
| S5000 |
Prescription drug, generic |
3,456 |
3,261 |
$26K |
| 81025 |
|
6,776 |
6,650 |
$26K |
| 99401 |
|
1,234 |
1,226 |
$24K |
| S0190 |
Mifepristone, oral, 200 mg |
427 |
427 |
$22K |
| 99402 |
|
696 |
692 |
$22K |
| S9445 |
Pt education noc individ |
1,575 |
1,575 |
$20K |
| 58301 |
|
550 |
287 |
$18K |
| 83986 |
|
6,674 |
5,491 |
$17K |
| Q0111 |
Wet mounts/ w preparations |
4,450 |
4,345 |
$15K |
| 57454 |
|
238 |
121 |
$14K |
| 55250 |
|
79 |
40 |
$11K |
| 59840 |
|
48 |
24 |
$8K |
| 85018 |
|
538 |
498 |
$4K |
| Q3014 |
Telehealth facility fee |
213 |
213 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
1,137 |
1,044 |
$3K |
| G2012 |
Brief check in by md/qhp |
256 |
249 |
$3K |
| 81002 |
|
1,483 |
1,443 |
$3K |
| 87591 |
|
1,292 |
1,287 |
$2K |
| J7303 |
Contraceptive vaginal ring |
18 |
18 |
$2K |
| 87491 |
|
1,279 |
1,274 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
324 |
313 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
461 |
456 |
$1K |
| T1999 |
Noc retail items andsupplies |
62 |
36 |
$749.00 |
| 0270 |
|
99 |
65 |
$526.38 |
| T1014 |
Telehealth transmit, per min |
211 |
211 |
$277.27 |
| 86901 |
|
25 |
25 |
$101.92 |
| J3010 |
Fentanyl citrate injection |
12 |
12 |
$30.72 |
| J2250 |
Inj midazolam hydrochloride |
12 |
12 |
$13.16 |