| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1017 |
Targeted case management, each 15 minutes |
3,095 |
2,754 |
$275K |
| T1016 |
Case management, each 15 minutes |
2,173 |
1,681 |
$108K |
| H1010 |
Non-medical family planning education, per session |
1,597 |
1,281 |
$76K |
| H1003 |
Prenatal care, at-risk enhanced service; education |
1,729 |
1,276 |
$56K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,884 |
2,473 |
$43K |
| H1004 |
Prenatal care, at-risk enhanced service; follow-up home visit |
1,396 |
1,040 |
$41K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,973 |
2,734 |
$34K |
| S4993 |
Contraceptive pills for birth control |
782 |
517 |
$31K |
| 99188 |
|
1,965 |
1,673 |
$24K |
| 99000 |
|
2,886 |
2,464 |
$11K |
| H1000 |
Prenatal care, at-risk assessment |
267 |
227 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
405 |
365 |
$7K |
| 81025 |
|
924 |
798 |
$7K |
| A4268 |
Contraceptive supply, condom, female, each |
851 |
701 |
$5K |
| A4267 |
Contraceptive supply, condom, male, each |
971 |
806 |
$4K |
| 90715 |
|
389 |
367 |
$2K |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
57 |
52 |
$2K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
77 |
67 |
$2K |
| 90651 |
|
332 |
321 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
77 |
67 |
$2K |
| 90633 |
|
358 |
318 |
$2K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
56 |
36 |
$2K |
| 90670 |
|
380 |
340 |
$2K |
| 90686 |
|
462 |
408 |
$2K |
| 86580 |
|
291 |
251 |
$2K |
| 90698 |
|
223 |
194 |
$1K |
| 90734 |
|
240 |
226 |
$909.66 |
| 90710 |
|
197 |
176 |
$862.70 |
| 90688 |
|
45 |
44 |
$856.66 |
| 90619 |
|
64 |
63 |
$789.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
297 |
257 |
$744.65 |
| 83655 |
|
62 |
62 |
$714.82 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
25 |
25 |
$604.94 |
| 81002 |
|
231 |
206 |
$602.04 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
223 |
187 |
$381.83 |
| 86592 |
|
109 |
97 |
$335.46 |
| 90696 |
|
63 |
56 |
$253.19 |
| 90656 |
|
16 |
16 |
$240.00 |
| 90623 |
|
13 |
13 |
$195.00 |
| 90744 |
|
32 |
27 |
$164.96 |
| 36416 |
|
50 |
50 |
$132.62 |
| 90716 |
|
27 |
27 |
$123.58 |
| 90680 |
|
24 |
24 |
$108.96 |
| 90685 |
|
29 |
26 |
$95.99 |
| 90648 |
|
13 |
13 |
$61.48 |
| 90707 |
|
16 |
16 |
$60.34 |
| 90723 |
|
12 |
12 |
$54.48 |
| 85018 |
|
12 |
12 |
$31.56 |