| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
19,371 |
18,812 |
$2.01M |
| 99203 |
|
6,367 |
6,318 |
$1.62M |
| 99214 |
|
7,147 |
6,948 |
$1.17M |
| 99202 |
|
7,209 |
7,034 |
$1.01M |
| 99212 |
|
10,780 |
10,391 |
$774K |
| S4993 |
Contraceptive pills for bc |
6,127 |
6,085 |
$758K |
| 87806 |
|
31,525 |
26,049 |
$754K |
| J3490 |
Drugs unclassified injection |
10,665 |
9,375 |
$508K |
| 59840 |
|
1,527 |
1,520 |
$442K |
| S0199 |
Med abortion inc all ex drug |
748 |
744 |
$386K |
| J7307 |
Etonogestrel implant system |
437 |
406 |
$346K |
| J7304 |
Contraceptive hormone patch |
284 |
280 |
$242K |
| 99201 |
|
2,158 |
2,076 |
$176K |
| 99211 |
|
3,039 |
3,008 |
$147K |
| 58300 |
|
952 |
603 |
$88K |
| 11981 |
|
397 |
397 |
$77K |
| 81025 |
|
22,235 |
21,957 |
$68K |
| S9445 |
Pt education noc individ |
4,972 |
4,972 |
$63K |
| 76817 |
|
1,195 |
1,151 |
$58K |
| J7298 |
Mirena, 52 mg |
65 |
63 |
$53K |
| 99000 |
|
14,382 |
14,143 |
$50K |
| A4267 |
Male condom |
5,301 |
5,208 |
$41K |
| 99152 |
|
838 |
835 |
$36K |
| J7297 |
Liletta, 52 mg |
61 |
59 |
$35K |
| 87491 |
|
1,133 |
1,128 |
$33K |
| 87591 |
|
1,134 |
1,129 |
$33K |
| J1050 |
Medroxyprogesterone acetate |
402 |
400 |
$33K |
| S5000 |
Prescription drug, generic |
4,373 |
4,184 |
$31K |
| J7300 |
Intra copp contra (paragard) |
36 |
36 |
$23K |
| 83986 |
|
7,574 |
6,736 |
$19K |
| 59841 |
|
43 |
43 |
$15K |
| 87661 |
|
425 |
424 |
$15K |
| 99204 |
|
44 |
43 |
$14K |
| 87210 |
|
4,555 |
4,497 |
$14K |
| S0190 |
Mifepristone, oral, 200 mg |
218 |
212 |
$12K |
| 86701 |
|
1,563 |
1,183 |
$10K |
| 11976 |
|
91 |
90 |
$9K |
| 58301 |
|
249 |
143 |
$8K |
| 55250 |
|
50 |
25 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral |
1,195 |
850 |
$6K |
| 99401 |
|
280 |
280 |
$5K |
| J7303 |
Contraceptive vaginal ring |
24 |
24 |
$4K |
| S5199 |
Personal care item nos each |
613 |
613 |
$3K |
| 85018 |
|
1,618 |
1,582 |
$2K |
| 81002 |
|
1,181 |
1,173 |
$2K |
| 96372 |
|
75 |
75 |
$1K |
| S0191 |
Misoprostol, oral, 200 mcg |
367 |
352 |
$914.52 |
| 76998 |
|
12 |
12 |
$714.27 |
| 76815 |
|
15 |
15 |
$571.23 |
| 36415 |
|
386 |
364 |
$268.50 |
| 86901 |
|
294 |
285 |
$168.73 |
| J0696 |
Ceftriaxone sodium injection |
13 |
13 |
$82.55 |