| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
23,010 |
20,823 |
$2.12M |
| S4993 |
Contraceptive pills for birth control |
17,991 |
10,836 |
$1.33M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,919 |
4,736 |
$282K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,527 |
6,180 |
$234K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
5,941 |
5,018 |
$154K |
| A4267 |
Contraceptive supply, condom, male, each |
11,747 |
11,135 |
$146K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,084 |
1,990 |
$82K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
3,899 |
3,825 |
$68K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
579 |
563 |
$55K |
| 87806 |
|
1,967 |
1,893 |
$49K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
730 |
705 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,511 |
1,435 |
$41K |
| 99000 |
|
10,913 |
10,375 |
$38K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,098 |
2,069 |
$31K |
| 87210 |
|
4,915 |
4,714 |
$27K |
| 81025 |
|
2,624 |
2,521 |
$22K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
970 |
934 |
$17K |
| J3490 |
Unclassified drugs |
525 |
505 |
$5K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
14 |
13 |
$5K |
| 81002 |
|
1,085 |
1,051 |
$4K |
| 86703 |
|
162 |
159 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
72 |
71 |
$2K |
| 11982 |
|
12 |
12 |
$1K |
| 87563 |
|
43 |
43 |
$1K |
| 11981 |
|
12 |
12 |
$993.00 |
| 58300 |
|
29 |
25 |
$815.04 |
| 99201 |
|
29 |
28 |
$742.56 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
309 |
289 |
$241.93 |