| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
1,795 |
1,441 |
$385K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,166 |
2,054 |
$264K |
| A4267 |
Contraceptive supply, condom, male, each |
1,273 |
1,013 |
$39K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
614 |
504 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
833 |
717 |
$37K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
33 |
24 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
153 |
145 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
246 |
207 |
$11K |
| 81025 |
|
696 |
599 |
$5K |
| 87210 |
|
380 |
360 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
78 |
48 |
$736.44 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
28 |
$422.29 |
| 81002 |
|
28 |
28 |
$88.14 |