| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
15,499 |
14,212 |
$1.41M |
| S4993 |
Contraceptive pills for birth control |
10,871 |
6,635 |
$779K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,060 |
4,825 |
$175K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,252 |
2,175 |
$126K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
3,504 |
2,804 |
$95K |
| A4267 |
Contraceptive supply, condom, male, each |
6,121 |
5,790 |
$76K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,655 |
3,589 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
966 |
946 |
$62K |
| 87806 |
|
2,427 |
2,344 |
$61K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,507 |
1,453 |
$54K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,273 |
2,222 |
$32K |
| 99000 |
|
6,770 |
6,475 |
$24K |
| 81025 |
|
2,039 |
1,982 |
$17K |
| 87210 |
|
2,774 |
2,682 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
147 |
136 |
$14K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
676 |
641 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
438 |
424 |
$12K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
25 |
25 |
$10K |
| 86703 |
|
226 |
226 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
84 |
80 |
$2K |
| 81002 |
|
504 |
487 |
$2K |
| 11981 |
|
13 |
13 |
$1K |
| J3490 |
Unclassified drugs |
70 |
68 |
$857.76 |