| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
10,668 |
10,076 |
$746K |
| J7307 |
Etonogestrel implant system |
573 |
568 |
$477K |
| J3490 |
Drugs unclassified injection |
9,428 |
7,889 |
$279K |
| S4993 |
Contraceptive pills for bc |
2,743 |
2,709 |
$238K |
| 99203 |
|
1,235 |
1,232 |
$232K |
| 99202 |
|
1,874 |
1,851 |
$206K |
| 99214 |
|
2,091 |
2,026 |
$197K |
| 99212 |
|
2,872 |
2,809 |
$174K |
| 11981 |
|
645 |
642 |
$119K |
| 87806 |
|
6,126 |
5,204 |
$111K |
| 99211 |
|
5,578 |
5,334 |
$91K |
| 99401 |
|
3,881 |
3,727 |
$74K |
| 99201 |
|
686 |
666 |
$60K |
| 58300 |
|
629 |
321 |
$47K |
| 11976 |
|
762 |
384 |
$38K |
| J7304 |
Contraceptive hormone patch |
59 |
59 |
$33K |
| A4267 |
Male condom |
4,115 |
4,050 |
$26K |
| 87661 |
|
1,295 |
1,287 |
$24K |
| 58301 |
|
823 |
425 |
$20K |
| 83986 |
|
7,112 |
6,231 |
$16K |
| S5000 |
Prescription drug, generic |
2,296 |
2,165 |
$16K |
| 81025 |
|
6,543 |
6,423 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
5,129 |
4,980 |
$14K |
| J7298 |
Mirena, 52 mg |
25 |
25 |
$13K |
| 99000 |
|
4,799 |
4,714 |
$11K |
| J7300 |
Intra copp contra (paragard) |
16 |
16 |
$10K |
| S0199 |
Med abortion inc all ex drug |
35 |
35 |
$8K |
| 87491 |
|
2,314 |
2,293 |
$4K |
| S9445 |
Pt education noc individ |
348 |
348 |
$4K |
| 11982 |
|
247 |
125 |
$4K |
| 87591 |
|
2,284 |
2,263 |
$2K |
| 81002 |
|
1,811 |
1,777 |
$2K |
| J7303 |
Contraceptive vaginal ring |
16 |
16 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
614 |
564 |
$2K |
| S0190 |
Mifepristone, oral, 200 mg |
46 |
46 |
$1K |
| 76815 |
|
32 |
31 |
$1K |
| J8499 |
Oral prescrip drug non chemo |
72 |
48 |
$805.85 |
| Q3014 |
Telehealth facility fee |
30 |
29 |
$297.99 |
| J0696 |
Ceftriaxone sodium injection |
80 |
76 |
$271.23 |
| G2012 |
Brief check in by md/qhp |
57 |
55 |
$233.07 |
| 90686 |
|
16 |
16 |
$93.96 |
| Z7610 |
|
13 |
12 |
$92.79 |
| S0191 |
Misoprostol, oral, 200 mcg |
59 |
59 |
$81.15 |
| T1014 |
Telehealth transmit, per min |
30 |
29 |
$30.68 |
| 90630 |
|
14 |
14 |
$24.80 |
| 90471 |
|
67 |
65 |
$0.00 |