| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0199 |
Med abortion inc all ex drug |
5,218 |
5,139 |
$460K |
| 99212 |
|
10,676 |
10,039 |
$254K |
| J7307 |
Etonogestrel implant system |
548 |
541 |
$253K |
| S4993 |
Contraceptive pills for bc |
1,839 |
1,809 |
$144K |
| J3490 |
Drugs unclassified injection |
9,467 |
8,320 |
$125K |
| 99202 |
|
2,842 |
2,821 |
$96K |
| 58300 |
|
1,407 |
715 |
$72K |
| 90651 |
|
696 |
690 |
$66K |
| 59840 |
|
2,156 |
1,133 |
$56K |
| 11981 |
|
557 |
551 |
$51K |
| J7298 |
Mirena, 52 mg |
75 |
74 |
$50K |
| A4267 |
Male condom |
10,223 |
9,975 |
$47K |
| S0190 |
Mifepristone, oral, 200 mg |
3,792 |
3,761 |
$41K |
| G9920 |
Scrning perf and negative |
4,226 |
4,203 |
$31K |
| 76815 |
|
2,454 |
2,405 |
$17K |
| 11976 |
|
370 |
193 |
$11K |
| 99152 |
|
1,096 |
1,080 |
$8K |
| 76817 |
|
965 |
923 |
$7K |
| 99201 |
|
312 |
311 |
$4K |
| G9919 |
Scrn nd pos nd prov of rec |
431 |
430 |
$4K |
| 58301 |
|
235 |
119 |
$3K |
| Q0144 |
Azithromycin dihydrate, oral |
1,735 |
1,603 |
$3K |
| S9445 |
Pt education noc individ |
160 |
160 |
$2K |
| S0191 |
Misoprostol, oral, 200 mcg |
4,184 |
4,137 |
$2K |
| G2012 |
Brief check in by md/qhp |
665 |
639 |
$2K |
| 99211 |
|
72 |
70 |
$1K |
| T1014 |
Telehealth transmit, per min |
432 |
420 |
$877.89 |
| 85018 |
|
1,074 |
1,028 |
$757.96 |
| 99213 |
|
301 |
286 |
$610.28 |
| 01966 |
|
34 |
34 |
$310.50 |
| 11982 |
|
26 |
13 |
$243.86 |
| 76998 |
|
13 |
13 |
$233.10 |
| 76830 |
|
14 |
14 |
$202.27 |
| 83986 |
|
110 |
100 |
$76.90 |
| 81025 |
|
201 |
192 |
$72.80 |
| Q0111 |
Wet mounts/ w preparations |
73 |
63 |
$64.56 |
| 99203 |
|
15 |
15 |
$57.20 |
| 87591 |
|
161 |
161 |
$0.00 |
| 87661 |
|
166 |
164 |
$0.00 |
| 88142 |
|
13 |
13 |
$0.00 |
| 87491 |
|
163 |
161 |
$0.00 |
| 87806 |
|
31 |
31 |
$0.00 |