| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
5,163 |
4,929 |
$703K |
| 99213 |
|
6,451 |
6,140 |
$579K |
| J3490 |
Drugs unclassified injection |
10,709 |
9,364 |
$355K |
| 99212 |
|
4,795 |
4,635 |
$308K |
| 87806 |
|
11,203 |
9,802 |
$289K |
| 99211 |
|
5,802 |
5,432 |
$275K |
| S4993 |
Contraceptive pills for bc |
1,609 |
1,584 |
$182K |
| 99202 |
|
1,256 |
1,231 |
$162K |
| 99203 |
|
751 |
713 |
$152K |
| 99204 |
|
284 |
281 |
$71K |
| S0199 |
Med abortion inc all ex drug |
146 |
144 |
$69K |
| A4267 |
Male condom |
7,021 |
6,954 |
$49K |
| 81025 |
|
12,039 |
11,797 |
$36K |
| 99000 |
|
7,597 |
7,433 |
$29K |
| S5000 |
Prescription drug, generic |
5,041 |
4,478 |
$27K |
| 83986 |
|
7,477 |
6,626 |
$23K |
| 99201 |
|
210 |
210 |
$22K |
| 82120 |
|
3,690 |
3,581 |
$15K |
| Q0111 |
Wet mounts/ w preparations |
3,408 |
3,345 |
$13K |
| J7304 |
Contraceptive hormone patch |
26 |
26 |
$13K |
| S5199 |
Personal care item nos each |
6,707 |
6,624 |
$13K |
| J7307 |
Etonogestrel implant system |
14 |
14 |
$12K |
| S9445 |
Pt education noc individ |
882 |
882 |
$11K |
| 87210 |
|
2,084 |
2,042 |
$8K |
| 11976 |
|
111 |
54 |
$7K |
| Q0144 |
Azithromycin dihydrate, oral |
1,222 |
1,080 |
$7K |
| S0190 |
Mifepristone, oral, 200 mg |
111 |
109 |
$7K |
| 76817 |
|
41 |
37 |
$4K |
| 11981 |
|
14 |
14 |
$3K |
| 81002 |
|
1,021 |
990 |
$2K |
| 99401 |
|
42 |
41 |
$791.87 |
| J0696 |
Ceftriaxone sodium injection |
128 |
121 |
$646.19 |
| S0191 |
Misoprostol, oral, 200 mcg |
130 |
124 |
$380.36 |
| 90791 |
|
90 |
88 |
$0.00 |