| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
9,800 |
9,563 |
$969K |
| 87491 |
|
18,659 |
16,839 |
$541K |
| J3490 |
Drugs unclassified injection |
19,863 |
16,680 |
$536K |
| 87591 |
|
18,621 |
16,841 |
$521K |
| S4993 |
Contraceptive pills for bc |
3,623 |
3,571 |
$464K |
| 99214 |
|
2,832 |
2,791 |
$426K |
| 99202 |
|
2,365 |
2,351 |
$403K |
| 99211 |
|
5,324 |
5,272 |
$298K |
| 87806 |
|
12,554 |
10,366 |
$272K |
| 99203 |
|
900 |
896 |
$219K |
| 99212 |
|
2,520 |
2,460 |
$214K |
| 87661 |
|
2,272 |
2,263 |
$67K |
| 81025 |
|
13,792 |
13,548 |
$43K |
| A4267 |
Male condom |
9,934 |
9,866 |
$40K |
| S5199 |
Personal care item nos each |
3,981 |
3,957 |
$30K |
| 99000 |
|
8,518 |
8,479 |
$28K |
| Q3014 |
Telehealth facility fee |
1,446 |
1,397 |
$26K |
| S9445 |
Pt education noc individ |
1,795 |
1,795 |
$23K |
| 99204 |
|
79 |
79 |
$23K |
| J7307 |
Etonogestrel implant system |
29 |
29 |
$20K |
| S5000 |
Prescription drug, generic |
1,704 |
1,604 |
$13K |
| 83986 |
|
3,394 |
3,062 |
$9K |
| 11981 |
|
27 |
27 |
$8K |
| 99201 |
|
54 |
54 |
$7K |
| 87210 |
|
2,056 |
2,023 |
$6K |
| Q0144 |
Azithromycin dihydrate, oral |
843 |
583 |
$5K |
| G8510 |
Scr dep neg, no plan reqd |
561 |
561 |
$4K |
| S5001 |
Prescription drug,brand name |
806 |
785 |
$4K |
| 81002 |
|
685 |
680 |
$1K |
| J8499 |
Oral prescrip drug non chemo |
237 |
207 |
$587.82 |
| 0012A |
|
14 |
14 |
$560.00 |
| 0011A |
|
14 |
14 |
$560.00 |
| 82120 |
|
117 |
116 |
$255.88 |
| Q0111 |
Wet mounts/ w preparations |
32 |
31 |
$116.38 |
| J0696 |
Ceftriaxone sodium injection |
12 |
12 |
$50.00 |
| 36415 |
|
28 |
27 |
$0.00 |