| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
6,196 |
5,868 |
$880K |
| 99213 |
|
6,624 |
6,170 |
$641K |
| J3490 |
Drugs unclassified injection |
13,715 |
11,887 |
$479K |
| S4993 |
Contraceptive pills for bc |
3,015 |
2,986 |
$342K |
| 99211 |
|
6,979 |
6,405 |
$340K |
| 87806 |
|
13,080 |
11,340 |
$339K |
| 99212 |
|
3,520 |
3,406 |
$239K |
| 99204 |
|
617 |
614 |
$158K |
| 99203 |
|
682 |
651 |
$157K |
| 99202 |
|
1,107 |
1,041 |
$152K |
| 59840 |
|
753 |
378 |
$137K |
| J7307 |
Etonogestrel implant system |
143 |
140 |
$120K |
| J7304 |
Contraceptive hormone patch |
149 |
145 |
$94K |
| S0199 |
Med abortion inc all ex drug |
151 |
151 |
$71K |
| 99201 |
|
582 |
561 |
$58K |
| A4267 |
Male condom |
6,674 |
6,615 |
$47K |
| 81025 |
|
14,537 |
14,258 |
$44K |
| 99000 |
|
8,600 |
8,404 |
$34K |
| 11981 |
|
143 |
140 |
$31K |
| S5000 |
Prescription drug, generic |
4,847 |
4,305 |
$29K |
| 83986 |
|
6,790 |
6,077 |
$21K |
| 58300 |
|
168 |
84 |
$15K |
| S9445 |
Pt education noc individ |
1,072 |
1,072 |
$14K |
| Q0111 |
Wet mounts/ w preparations |
3,486 |
3,432 |
$13K |
| 11976 |
|
219 |
110 |
$12K |
| J7298 |
Mirena, 52 mg |
16 |
16 |
$11K |
| 99152 |
|
210 |
208 |
$10K |
| 82120 |
|
2,241 |
2,175 |
$9K |
| J7300 |
Intra copp contra (paragard) |
12 |
12 |
$8K |
| 76815 |
|
115 |
114 |
$8K |
| Q0144 |
Azithromycin dihydrate, oral |
1,078 |
904 |
$6K |
| 64435 |
|
152 |
152 |
$6K |
| S5199 |
Personal care item nos each |
5,968 |
5,912 |
$6K |
| S0190 |
Mifepristone, oral, 200 mg |
90 |
90 |
$6K |
| J7303 |
Contraceptive vaginal ring |
43 |
43 |
$5K |
| 87210 |
|
1,290 |
1,255 |
$5K |
| 76817 |
|
33 |
31 |
$3K |
| 81002 |
|
1,106 |
1,083 |
$2K |
| 58301 |
|
54 |
27 |
$2K |
| 99401 |
|
67 |
67 |
$1K |
| J3010 |
Fentanyl citrate injection |
223 |
206 |
$1K |
| J2250 |
Inj midazolam hydrochloride |
214 |
196 |
$1K |
| 85018 |
|
333 |
327 |
$686.62 |
| S0191 |
Misoprostol, oral, 200 mcg |
139 |
137 |
$403.69 |
| J0696 |
Ceftriaxone sodium injection |
34 |
30 |
$166.89 |
| 90791 |
|
26 |
26 |
$0.00 |