| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
3,903 |
2,989 |
$742K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,977 |
2,898 |
$365K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
866 |
762 |
$46K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
383 |
355 |
$27K |
| A4267 |
Contraceptive supply, condom, male, each |
1,161 |
1,076 |
$27K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
29 |
26 |
$22K |
| 81025 |
|
2,211 |
2,079 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
204 |
178 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
28 |
$1K |
| 87210 |
|
224 |
196 |
$826.08 |
| 86703 |
|
14 |
14 |
$153.53 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
12 |
$132.27 |
| 81002 |
|
13 |
13 |
$31.72 |
| 83986 |
|
13 |
13 |
$30.12 |
| 36415 |
Collection of venous blood by venipuncture |
14 |
13 |
$27.30 |
| 36416 |
|
14 |
14 |
$14.70 |