| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
7,002 |
6,692 |
$948K |
| 99213 |
|
7,663 |
7,385 |
$705K |
| 87806 |
|
19,886 |
16,659 |
$455K |
| J3490 |
Drugs unclassified injection |
11,812 |
10,500 |
$344K |
| 99203 |
|
1,249 |
1,232 |
$293K |
| 99212 |
|
4,444 |
4,382 |
$288K |
| 99211 |
|
4,716 |
4,315 |
$232K |
| S4993 |
Contraceptive pills for bc |
2,089 |
2,062 |
$213K |
| 99202 |
|
1,488 |
1,450 |
$207K |
| 99204 |
|
578 |
577 |
$139K |
| 90651 |
|
314 |
314 |
$56K |
| 99201 |
|
385 |
385 |
$43K |
| 99000 |
|
11,387 |
11,305 |
$42K |
| S5000 |
Prescription drug, generic |
6,064 |
5,474 |
$28K |
| 81025 |
|
10,514 |
10,366 |
$28K |
| S9445 |
Pt education noc individ |
2,138 |
2,138 |
$27K |
| 83986 |
|
9,564 |
8,139 |
$25K |
| S0199 |
Med abortion inc all ex drug |
64 |
64 |
$25K |
| A4267 |
Male condom |
2,723 |
2,717 |
$17K |
| Q0111 |
Wet mounts/ w preparations |
4,016 |
3,972 |
$14K |
| J7307 |
Etonogestrel implant system |
13 |
13 |
$11K |
| 82120 |
|
2,856 |
2,772 |
$9K |
| 58300 |
|
76 |
39 |
$6K |
| 87210 |
|
1,887 |
1,867 |
$5K |
| S5199 |
Personal care item nos each |
2,156 |
2,151 |
$5K |
| 11976 |
|
74 |
39 |
$4K |
| Q0144 |
Azithromycin dihydrate, oral |
627 |
558 |
$3K |
| 81002 |
|
1,792 |
1,765 |
$3K |
| 11981 |
|
13 |
13 |
$3K |
| 76817 |
|
31 |
31 |
$2K |
| 58301 |
|
68 |
36 |
$2K |
| 99401 |
|
87 |
86 |
$2K |
| S0190 |
Mifepristone, oral, 200 mg |
14 |
14 |
$659.60 |
| J0696 |
Ceftriaxone sodium injection |
28 |
28 |
$135.97 |
| S0191 |
Misoprostol, oral, 200 mcg |
43 |
43 |
$106.20 |