| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
6,371 |
5,836 |
$493K |
| S4993 |
Contraceptive pills for birth control |
6,623 |
5,072 |
$482K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,032 |
1,004 |
$63K |
| A4267 |
Contraceptive supply, condom, male, each |
3,002 |
2,720 |
$51K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
831 |
801 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,856 |
1,747 |
$46K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,557 |
2,416 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
805 |
758 |
$25K |
| 81025 |
|
1,430 |
1,340 |
$12K |
| 99000 |
|
3,187 |
2,842 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
144 |
131 |
$5K |
| 81002 |
|
737 |
686 |
$2K |
| A4268 |
Contraceptive supply, condom, female, each |
332 |
317 |
$2K |
| 99201 |
|
111 |
98 |
$2K |
| 87210 |
|
317 |
302 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
80 |
69 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$605.44 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
518 |
419 |
$472.85 |
| 0011A |
|
15 |
13 |
$220.22 |