| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
3,424 |
2,772 |
$305K |
| H1010 |
Non-medical family planning education, per session |
3,404 |
3,249 |
$299K |
| A4267 |
Contraceptive supply, condom, male, each |
1,043 |
1,015 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
356 |
345 |
$16K |
| 99000 |
|
692 |
673 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
30 |
$358.78 |
| 81025 |
|
40 |
39 |
$344.40 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
69 |
68 |
$326.07 |