| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
|
14,015 |
12,926 |
$745K |
| J3490 |
Drugs unclassified injection |
19,901 |
16,766 |
$673K |
| 99213 |
|
5,190 |
4,852 |
$658K |
| 99212 |
|
5,820 |
5,596 |
$529K |
| J7307 |
Etonogestrel implant system |
500 |
500 |
$459K |
| S4993 |
Contraceptive pills for bc |
3,813 |
3,777 |
$350K |
| 99202 |
|
1,517 |
1,474 |
$293K |
| 99203 |
|
753 |
726 |
$241K |
| 87806 |
|
8,949 |
7,026 |
$220K |
| 99201 |
|
1,751 |
1,605 |
$218K |
| 99214 |
|
726 |
667 |
$149K |
| 11981 |
|
472 |
472 |
$111K |
| J7304 |
Contraceptive hormone patch |
377 |
375 |
$106K |
| A4267 |
Male condom |
15,195 |
14,790 |
$90K |
| 81025 |
|
17,204 |
16,576 |
$56K |
| 11976 |
|
738 |
376 |
$42K |
| 99401 |
|
1,958 |
1,944 |
$37K |
| S5000 |
Prescription drug, generic |
4,225 |
3,932 |
$28K |
| S9445 |
Pt education noc individ |
2,078 |
2,078 |
$26K |
| J7303 |
Contraceptive vaginal ring |
308 |
305 |
$23K |
| 58300 |
|
255 |
125 |
$22K |
| 99000 |
|
5,341 |
5,324 |
$19K |
| 83986 |
|
5,331 |
4,359 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
3,442 |
3,355 |
$13K |
| 99204 |
|
31 |
31 |
$12K |
| 87491 |
|
579 |
559 |
$10K |
| 86703 |
|
942 |
822 |
$10K |
| 87591 |
|
572 |
552 |
$10K |
| 58301 |
|
186 |
97 |
$5K |
| Q0144 |
Azithromycin dihydrate, oral |
1,141 |
1,117 |
$4K |
| 87389 |
|
206 |
204 |
$3K |
| 81002 |
|
1,419 |
1,388 |
$3K |
| 86592 |
|
823 |
820 |
$2K |
| 99402 |
|
14 |
14 |
$445.06 |
| 82120 |
|
123 |
122 |
$358.60 |
| 87210 |
|
122 |
121 |
$331.17 |
| J0696 |
Ceftriaxone sodium injection |
63 |
63 |
$326.65 |
| 99070 |
|
35 |
25 |
$0.03 |