| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
8,515 |
8,107 |
$1.20M |
| 99213 |
|
9,075 |
8,683 |
$870K |
| J3490 |
Drugs unclassified injection |
15,448 |
13,542 |
$518K |
| 87806 |
|
19,650 |
16,948 |
$469K |
| 99211 |
|
6,843 |
6,319 |
$318K |
| 99203 |
|
1,330 |
1,294 |
$316K |
| 99212 |
|
4,234 |
4,170 |
$287K |
| S4993 |
Contraceptive pills for bc |
2,478 |
2,447 |
$268K |
| J7307 |
Etonogestrel implant system |
204 |
204 |
$165K |
| J7304 |
Contraceptive hormone patch |
290 |
286 |
$157K |
| 99202 |
|
711 |
681 |
$108K |
| 99204 |
|
380 |
380 |
$100K |
| 90651 |
|
357 |
355 |
$75K |
| 81025 |
|
17,125 |
16,934 |
$46K |
| 99000 |
|
11,823 |
11,731 |
$45K |
| 11981 |
|
204 |
204 |
$42K |
| A4267 |
Male condom |
6,236 |
6,207 |
$41K |
| S5000 |
Prescription drug, generic |
6,953 |
6,195 |
$31K |
| 99201 |
|
276 |
276 |
$28K |
| 83986 |
|
9,719 |
8,705 |
$27K |
| 90837 |
|
165 |
66 |
$20K |
| 11976 |
|
357 |
182 |
$19K |
| Q0111 |
Wet mounts/ w preparations |
4,796 |
4,722 |
$16K |
| S9445 |
Pt education noc individ |
1,276 |
1,276 |
$16K |
| 59840 |
|
112 |
57 |
$15K |
| 58300 |
|
155 |
80 |
$12K |
| 57454 |
|
212 |
105 |
$12K |
| 82120 |
|
3,402 |
3,319 |
$12K |
| J7298 |
Mirena, 52 mg |
12 |
12 |
$8K |
| S0199 |
Med abortion inc all ex drug |
12 |
12 |
$7K |
| S5199 |
Personal care item nos each |
5,913 |
5,871 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral |
926 |
814 |
$5K |
| 87210 |
|
1,578 |
1,558 |
$5K |
| 58301 |
|
89 |
46 |
$2K |
| 81002 |
|
1,050 |
1,031 |
$2K |
| 76817 |
|
28 |
27 |
$2K |
| 57452 |
|
23 |
12 |
$736.15 |
| J0696 |
Ceftriaxone sodium injection |
119 |
106 |
$575.23 |
| 99401 |
|
26 |
26 |
$448.18 |
| 99152 |
|
16 |
16 |
$443.18 |
| J2250 |
Inj midazolam hydrochloride |
29 |
25 |
$263.14 |
| J3010 |
Fentanyl citrate injection |
33 |
25 |
$209.65 |
| 85018 |
|
55 |
55 |
$98.74 |
| 36415 |
|
15 |
12 |
$0.00 |