| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
14,033 |
12,798 |
$1.18M |
| S4993 |
Contraceptive pills for birth control |
8,626 |
5,453 |
$617K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,397 |
5,055 |
$161K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,589 |
2,464 |
$123K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,767 |
1,681 |
$58K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
3,018 |
2,423 |
$58K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
870 |
837 |
$47K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,589 |
2,519 |
$47K |
| A4267 |
Contraceptive supply, condom, male, each |
3,826 |
3,587 |
$46K |
| 87806 |
|
1,761 |
1,670 |
$43K |
| 99000 |
|
6,633 |
6,243 |
$23K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,627 |
1,576 |
$19K |
| 81025 |
|
1,998 |
1,887 |
$16K |
| 87210 |
|
2,409 |
2,280 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
142 |
140 |
$11K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
477 |
447 |
$8K |
| Q3014 |
Telehealth originating site facility fee |
313 |
291 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
139 |
133 |
$3K |
| 81002 |
|
655 |
612 |
$2K |
| J3490 |
Unclassified drugs |
110 |
106 |
$1K |
| 86703 |
|
32 |
32 |
$372.00 |