| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
5,142 |
4,757 |
$446K |
| S4993 |
Contraceptive pills for birth control |
3,184 |
2,050 |
$227K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,677 |
1,583 |
$47K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,181 |
1,134 |
$20K |
| A4267 |
Contraceptive supply, condom, male, each |
1,490 |
1,406 |
$18K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
546 |
517 |
$17K |
| 99000 |
|
2,057 |
1,950 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
549 |
520 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
118 |
108 |
$5K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
181 |
146 |
$4K |
| Q3014 |
Telehealth originating site facility fee |
177 |
158 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
70 |
$3K |
| 81025 |
|
147 |
137 |
$1K |
| 87806 |
|
26 |
25 |
$657.00 |
| 87210 |
|
39 |
39 |
$214.97 |
| 86703 |
|
12 |
12 |
$144.00 |