| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
218,697 |
206,826 |
$28.82M |
| J7307 |
Etonogestrel implant system |
26,001 |
25,885 |
$22.72M |
| 99213 |
|
231,814 |
215,767 |
$19.97M |
| 87491 |
|
593,191 |
536,134 |
$17.88M |
| 87591 |
|
582,904 |
528,147 |
$16.85M |
| S4993 |
Contraceptive pills for bc |
101,124 |
100,680 |
$13.77M |
| 99203 |
|
48,115 |
46,408 |
$10.91M |
| S0199 |
Med abortion inc all ex drug |
20,720 |
20,608 |
$9.97M |
| 99204 |
|
33,782 |
33,610 |
$8.50M |
| J3490 |
Drugs unclassified injection |
216,627 |
187,018 |
$8.09M |
| J7298 |
Mirena, 52 mg |
9,454 |
9,407 |
$7.26M |
| 99212 |
|
98,273 |
93,652 |
$6.50M |
| 11981 |
|
29,303 |
29,050 |
$6.12M |
| J7304 |
Contraceptive hormone patch |
4,987 |
4,952 |
$5.51M |
| 87806 |
|
217,019 |
187,639 |
$5.15M |
| 99202 |
|
39,828 |
38,343 |
$5.14M |
| J7300 |
Intra copp contra (paragard) |
7,230 |
7,196 |
$5.09M |
| 58300 |
|
43,059 |
21,850 |
$3.98M |
| A4267 |
Male condom |
434,195 |
421,760 |
$3.83M |
| 90651 |
|
13,278 |
13,202 |
$3.34M |
| 11976 |
|
55,667 |
28,436 |
$2.98M |
| 81025 |
|
586,932 |
556,663 |
$1.94M |
| 76817 |
|
24,033 |
22,118 |
$1.81M |
| 99211 |
|
32,124 |
31,733 |
$1.39M |
| 59840 |
|
8,690 |
4,573 |
$1.39M |
| S0190 |
Mifepristone, oral, 200 mg |
19,836 |
19,712 |
$1.07M |
| 58301 |
|
31,402 |
15,895 |
$882K |
| 57454 |
|
13,495 |
6,819 |
$777K |
| J7303 |
Contraceptive vaginal ring |
3,858 |
3,821 |
$641K |
| 99000 |
|
172,524 |
168,639 |
$626K |
| S5000 |
Prescription drug, generic |
132,155 |
119,900 |
$614K |
| Q3014 |
Telehealth facility fee |
28,243 |
25,626 |
$549K |
| Q0144 |
Azithromycin dihydrate, oral |
33,852 |
29,258 |
$497K |
| 83986 |
|
151,403 |
131,043 |
$419K |
| S9445 |
Pt education noc individ |
32,457 |
32,457 |
$413K |
| Q0111 |
Wet mounts/ w preparations |
113,397 |
111,062 |
$399K |
| 99201 |
|
3,790 |
3,691 |
$351K |
| J1050 |
Medroxyprogesterone acetate |
4,443 |
4,414 |
$319K |
| 99395 |
|
3,891 |
3,848 |
$295K |
| 90674 |
|
8,370 |
8,338 |
$250K |
| 59841 |
|
1,015 |
504 |
$238K |
| J7295 |
Eth estr and eton monthly |
1,332 |
1,332 |
$197K |
| 90837 |
|
1,448 |
639 |
$156K |
| 99243 |
|
2,411 |
2,391 |
$143K |
| 55250 |
|
888 |
448 |
$132K |
| 99401 |
|
6,843 |
6,827 |
$129K |
| 81002 |
|
43,528 |
42,592 |
$91K |
| S0191 |
Misoprostol, oral, 200 mcg |
19,294 |
18,964 |
$89K |
| 96156 |
|
1,207 |
1,203 |
$86K |
| 99385 |
|
397 |
396 |
$75K |
| 90471 |
|
14,211 |
14,001 |
$67K |
| 90834 |
|
805 |
463 |
$62K |
| J0696 |
Ceftriaxone sodium injection |
15,283 |
13,858 |
$60K |
| Z1034 |
|
1,061 |
1,020 |
$58K |
| 0011A |
|
1,423 |
1,416 |
$54K |
| 0012A |
|
1,039 |
1,029 |
$40K |
| 85018 |
|
12,037 |
11,427 |
$35K |
| 90746 |
|
550 |
548 |
$34K |
| S5001 |
Prescription drug,brand name |
14,650 |
14,384 |
$29K |
| 57460 |
|
260 |
130 |
$27K |
| 90715 |
|
592 |
585 |
$25K |
| G0442 |
Annual alcohol screen 15 min |
2,082 |
2,056 |
$23K |
| 99402 |
|
598 |
598 |
$19K |
| 0064A |
|
543 |
542 |
$18K |
| 56501 |
|
391 |
172 |
$18K |
| J0561 |
Penicillin g benzathine inj |
2,166 |
1,748 |
$18K |
| 76815 |
|
289 |
282 |
$17K |
| 76830 |
|
249 |
244 |
$17K |
| 86901 |
|
5,024 |
4,937 |
$15K |
| 87210 |
|
3,334 |
3,214 |
$15K |
| 99396 |
|
254 |
250 |
$12K |
| G8431 |
Pos clin depres scrn f/u doc |
770 |
765 |
$12K |
| 59425 |
|
207 |
202 |
$11K |
| Q0091 |
Obtaining screen pap smear |
283 |
283 |
$11K |
| 99442 |
|
2,373 |
2,270 |
$10K |
| 54056 |
|
247 |
113 |
$9K |
| J1885 |
Ketorolac tromethamine inj |
4,382 |
4,352 |
$9K |
| 99441 |
|
2,095 |
2,031 |
$8K |
| S0197 |
Prenatal vitamins 30 day |
2,438 |
2,405 |
$4K |
| G2012 |
Brief check in by md/qhp |
403 |
399 |
$4K |
| 90707 |
|
42 |
42 |
$4K |
| 83036 |
|
833 |
820 |
$3K |
| 90472 |
|
366 |
359 |
$3K |
| 76857 |
|
55 |
41 |
$2K |
| 0001A |
|
52 |
52 |
$2K |
| 90832 |
|
34 |
26 |
$2K |
| G0444 |
Depression screen annual |
76 |
76 |
$1K |
| 86580 |
|
73 |
66 |
$807.28 |
| G8510 |
Scr dep neg, no plan reqd |
374 |
374 |
$733.70 |
| 96127 |
|
173 |
161 |
$544.30 |
| 99242 |
|
12 |
12 |
$470.12 |
| 76882 |
|
13 |
12 |
$294.63 |
| 3074F |
|
1,310 |
1,290 |
$0.00 |
| 2000F |
|
342 |
320 |
$0.00 |
| 1036F |
|
766 |
746 |
$0.00 |
| H0001 |
Alcohol and/or drug assess |
91 |
91 |
$0.00 |
| 99443 |
|
42 |
38 |
$0.00 |
| 3008F |
|
53 |
53 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |
| 3078F |
|
1,215 |
1,197 |
$0.00 |
| 1160F |
|
1,074 |
1,051 |
$0.00 |
| 1159F |
|
1,075 |
1,053 |
$0.00 |
| 88147 |
|
627 |
619 |
$0.00 |
| 1158F |
|
52 |
52 |
$0.00 |