| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
|
4,972 |
4,798 |
$552K |
| S0199 |
Med abortion inc all ex drug |
540 |
539 |
$400K |
| 99212 |
|
4,126 |
4,012 |
$332K |
| S4993 |
Contraceptive pills for bc |
2,570 |
2,559 |
$307K |
| 99214 |
|
1,788 |
1,761 |
$296K |
| 99202 |
|
1,904 |
1,899 |
$284K |
| J3490 |
Drugs unclassified injection |
6,825 |
5,719 |
$271K |
| 99211 |
|
5,171 |
5,070 |
$225K |
| J7307 |
Etonogestrel implant system |
214 |
214 |
$188K |
| 87806 |
|
6,736 |
5,852 |
$173K |
| 99203 |
|
570 |
566 |
$150K |
| 99201 |
|
625 |
621 |
$61K |
| 11981 |
|
246 |
246 |
$55K |
| 58300 |
|
345 |
175 |
$36K |
| 76815 |
|
349 |
336 |
$32K |
| 87661 |
|
948 |
937 |
$29K |
| A4267 |
Male condom |
2,515 |
2,502 |
$28K |
| S0190 |
Mifepristone, oral, 200 mg |
479 |
478 |
$27K |
| 99204 |
|
85 |
85 |
$26K |
| 11976 |
|
354 |
189 |
$26K |
| 99000 |
|
4,947 |
4,866 |
$18K |
| T1999 |
Noc retail items andsupplies |
2,707 |
2,030 |
$17K |
| 81025 |
|
4,723 |
4,646 |
$14K |
| 99401 |
|
600 |
599 |
$11K |
| J7304 |
Contraceptive hormone patch |
12 |
12 |
$10K |
| Q0111 |
Wet mounts/ w preparations |
2,641 |
2,571 |
$10K |
| 83986 |
|
3,287 |
2,818 |
$10K |
| S5000 |
Prescription drug, generic |
1,125 |
1,043 |
$9K |
| Q3014 |
Telehealth facility fee |
278 |
274 |
$7K |
| S9445 |
Pt education noc individ |
390 |
390 |
$5K |
| 59840 |
|
24 |
12 |
$5K |
| 58301 |
|
81 |
41 |
$3K |
| 99402 |
|
60 |
60 |
$2K |
| G2012 |
Brief check in by md/qhp |
119 |
115 |
$2K |
| S0191 |
Misoprostol, oral, 200 mcg |
541 |
534 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
226 |
205 |
$1K |
| 87591 |
|
82 |
82 |
$1K |
| 87491 |
|
82 |
82 |
$933.60 |
| 81002 |
|
468 |
460 |
$843.74 |
| T1014 |
Telehealth transmit, per min |
269 |
265 |
$631.66 |
| 85018 |
|
166 |
163 |
$356.32 |
| J0696 |
Ceftriaxone sodium injection |
25 |
25 |
$120.21 |
| 86901 |
|
12 |
12 |
$30.12 |