| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Nonmed family planning ed |
26,970 |
24,907 |
$2.55M |
| S4993 |
Contraceptive pills for bc |
17,842 |
11,186 |
$1.32M |
| 99213 |
|
8,138 |
7,725 |
$255K |
| 99214 |
|
4,966 |
4,804 |
$253K |
| J8499 |
Oral prescrip drug non chemo |
5,607 |
4,688 |
$138K |
| A4267 |
Male condom |
9,563 |
9,123 |
$119K |
| J1050 |
Medroxyprogesterone acetate |
6,236 |
6,086 |
$108K |
| 99203 |
|
1,247 |
1,220 |
$69K |
| 87806 |
|
2,660 |
2,574 |
$67K |
| 99202 |
|
1,970 |
1,888 |
$66K |
| 99204 |
|
711 |
698 |
$58K |
| 99211 |
|
4,004 |
3,901 |
$49K |
| 99000 |
|
12,082 |
11,542 |
$41K |
| 99212 |
|
1,361 |
1,316 |
$34K |
| 87210 |
|
5,105 |
4,927 |
$29K |
| 81025 |
|
3,406 |
3,295 |
$28K |
| 57454 |
|
133 |
132 |
$16K |
| Q0144 |
Azithromycin dihydrate, oral |
816 |
757 |
$14K |
| J3490 |
Drugs unclassified injection |
815 |
783 |
$9K |
| J7307 |
Etonogestrel implant system |
13 |
13 |
$5K |
| 81002 |
|
1,314 |
1,263 |
$4K |
| 58300 |
|
81 |
77 |
$2K |
| J7304 |
Contraceptive hormone patch |
13 |
13 |
$2K |
| 11982 |
|
24 |
24 |
$2K |
| 57455 |
|
14 |
14 |
$2K |
| 86703 |
|
125 |
123 |
$1K |
| 58301 |
|
40 |
40 |
$1K |
| Q3014 |
Telehealth facility fee |
62 |
54 |
$1K |
| 87563 |
|
37 |
37 |
$955.70 |
| 99201 |
|
34 |
32 |
$755.82 |
| J0696 |
Ceftriaxone sodium injection |
42 |
40 |
$35.83 |