| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Nonmed family planning ed |
49,011 |
44,088 |
$4.51M |
| S4993 |
Contraceptive pills for bc |
40,137 |
23,174 |
$2.90M |
| 99214 |
|
11,395 |
10,994 |
$667K |
| 99213 |
|
14,112 |
13,183 |
$511K |
| J8499 |
Oral prescrip drug non chemo |
14,819 |
11,392 |
$342K |
| A4267 |
Male condom |
25,913 |
24,146 |
$316K |
| 99204 |
|
1,803 |
1,755 |
$176K |
| 99203 |
|
2,614 |
2,521 |
$168K |
| J7307 |
Etonogestrel implant system |
217 |
216 |
$158K |
| J1050 |
Medroxyprogesterone acetate |
8,583 |
8,373 |
$153K |
| 99202 |
|
3,437 |
3,222 |
$133K |
| 87806 |
|
3,668 |
3,487 |
$89K |
| 99000 |
|
22,952 |
21,835 |
$80K |
| 99211 |
|
4,392 |
4,293 |
$62K |
| 87210 |
|
10,795 |
10,455 |
$60K |
| 81025 |
|
7,175 |
6,904 |
$59K |
| 99212 |
|
1,850 |
1,795 |
$51K |
| Q0144 |
Azithromycin dihydrate, oral |
2,829 |
2,605 |
$48K |
| J7304 |
Contraceptive hormone patch |
239 |
235 |
$48K |
| J3490 |
Drugs unclassified injection |
3,030 |
2,909 |
$34K |
| 11982 |
|
191 |
186 |
$17K |
| 87563 |
|
553 |
542 |
$14K |
| 81002 |
|
2,947 |
2,795 |
$9K |
| 11981 |
|
62 |
61 |
$5K |
| Q3014 |
Telehealth facility fee |
222 |
215 |
$5K |
| 99201 |
|
92 |
89 |
$2K |
| J0696 |
Ceftriaxone sodium injection |
1,618 |
1,545 |
$1K |
| 86703 |
|
44 |
41 |
$531.96 |
| J7303 |
Contraceptive vaginal ring |
13 |
12 |
$294.48 |