| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0520 |
|
14,518 |
6,621 |
$2.22M |
| 0514 |
|
2,367 |
1,351 |
$675K |
| 99213 |
|
2,421 |
2,373 |
$330K |
| J3490 |
Drugs unclassified injection |
4,561 |
3,984 |
$236K |
| S4993 |
Contraceptive pills for bc |
1,659 |
1,644 |
$211K |
| 87806 |
|
5,459 |
4,657 |
$140K |
| 99202 |
|
654 |
653 |
$122K |
| 99212 |
|
1,167 |
1,151 |
$119K |
| 0510 |
|
197 |
191 |
$96K |
| 99214 |
|
352 |
349 |
$76K |
| 99201 |
|
545 |
542 |
$70K |
| 99203 |
|
221 |
221 |
$64K |
| 99211 |
|
969 |
962 |
$63K |
| 0300 |
|
5,850 |
3,687 |
$42K |
| 58300 |
|
198 |
105 |
$32K |
| S9445 |
Pt education noc individ |
1,894 |
1,894 |
$24K |
| S0190 |
Mifepristone, oral, 200 mg |
326 |
320 |
$20K |
| J7307 |
Etonogestrel implant system |
16 |
16 |
$14K |
| S5000 |
Prescription drug, generic |
1,076 |
1,011 |
$12K |
| 11981 |
|
29 |
29 |
$11K |
| 86703 |
|
1,022 |
861 |
$11K |
| 81025 |
|
3,379 |
3,307 |
$11K |
| A4267 |
Male condom |
1,266 |
1,259 |
$10K |
| 87591 |
|
283 |
279 |
$9K |
| 87491 |
|
264 |
262 |
$9K |
| 0320 |
|
115 |
112 |
$9K |
| 86780 |
|
801 |
800 |
$8K |
| 0270 |
|
828 |
709 |
$8K |
| S0199 |
Med abortion inc all ex drug |
12 |
12 |
$7K |
| 83986 |
|
1,953 |
1,586 |
$5K |
| 86803 |
|
229 |
223 |
$3K |
| 87808 |
|
287 |
287 |
$3K |
| Q0111 |
Wet mounts/ w preparations |
571 |
559 |
$2K |
| 11976 |
|
28 |
14 |
$2K |
| 58301 |
|
23 |
12 |
$1K |
| 99402 |
|
24 |
24 |
$762.96 |
| Q0144 |
Azithromycin dihydrate, oral |
133 |
85 |
$736.59 |
| S0191 |
Misoprostol, oral, 200 mcg |
336 |
325 |
$269.63 |
| 81002 |
|
43 |
43 |
$73.96 |
| 85018 |
|
33 |
32 |
$70.09 |