| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
8,509 |
7,713 |
$729K |
| S4993 |
Contraceptive pills for birth control |
6,460 |
3,782 |
$484K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,152 |
1,995 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,031 |
974 |
$47K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,226 |
1,180 |
$41K |
| A4267 |
Contraceptive supply, condom, male, each |
3,247 |
3,035 |
$39K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,817 |
1,748 |
$31K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
396 |
381 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
213 |
209 |
$19K |
| 87806 |
|
686 |
648 |
$17K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
854 |
688 |
$16K |
| 99000 |
|
4,517 |
4,261 |
$16K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,165 |
1,117 |
$14K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
290 |
274 |
$5K |
| 87210 |
|
745 |
704 |
$4K |
| 81025 |
|
221 |
211 |
$2K |
| 87563 |
|
69 |
64 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
71 |
67 |
$1K |
| 86703 |
|
114 |
113 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
27 |
27 |
$612.63 |
| J3490 |
Unclassified drugs |
12 |
12 |
$181.56 |
| 81002 |
|
13 |
13 |
$45.24 |