| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
4,451 |
4,339 |
$398K |
| 87491 |
|
9,694 |
8,453 |
$285K |
| 87591 |
|
9,605 |
8,436 |
$269K |
| J3490 |
Drugs unclassified injection |
9,502 |
8,448 |
$226K |
| 99203 |
|
808 |
808 |
$193K |
| 99214 |
|
1,612 |
1,598 |
$191K |
| 87806 |
|
7,670 |
6,989 |
$158K |
| S4993 |
Contraceptive pills for bc |
980 |
974 |
$111K |
| 87661 |
|
3,288 |
3,281 |
$94K |
| 99204 |
|
294 |
294 |
$82K |
| 99212 |
|
1,253 |
1,230 |
$81K |
| 99211 |
|
1,545 |
1,539 |
$79K |
| 99202 |
|
455 |
454 |
$54K |
| S5199 |
Personal care item nos each |
3,746 |
3,738 |
$29K |
| 81025 |
|
8,716 |
8,500 |
$26K |
| 99000 |
|
5,674 |
5,655 |
$17K |
| A4267 |
Male condom |
6,577 |
6,559 |
$13K |
| S5000 |
Prescription drug, generic |
1,745 |
1,635 |
$12K |
| S9445 |
Pt education noc individ |
415 |
415 |
$5K |
| G8510 |
Scr dep neg, no plan reqd |
623 |
620 |
$5K |
| 83986 |
|
1,750 |
1,611 |
$4K |
| 87210 |
|
990 |
983 |
$3K |
| Q3014 |
Telehealth facility fee |
62 |
60 |
$1K |
| 0011A |
|
28 |
28 |
$1K |
| 81002 |
|
648 |
643 |
$1K |
| S5001 |
Prescription drug,brand name |
282 |
277 |
$734.82 |
| 82120 |
|
294 |
293 |
$687.45 |
| J8499 |
Oral prescrip drug non chemo |
298 |
257 |
$649.27 |
| 0012A |
|
15 |
15 |
$600.00 |
| Q0111 |
Wet mounts/ w preparations |
50 |
49 |
$181.89 |
| 96372 |
|
13 |
13 |
$168.56 |
| 96127 |
|
26 |
26 |
$57.72 |
| 36415 |
|
134 |
131 |
$54.57 |
| Q0144 |
Azithromycin dihydrate, oral |
12 |
12 |
$47.16 |