| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
8,912 |
8,146 |
$898K |
| S4993 |
Contraceptive pills for birth control |
5,128 |
3,023 |
$400K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,660 |
2,519 |
$82K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,050 |
1,025 |
$55K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,420 |
1,399 |
$51K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,032 |
977 |
$48K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
500 |
478 |
$39K |
| 87806 |
|
1,441 |
1,392 |
$36K |
| A4267 |
Contraceptive supply, condom, male, each |
2,853 |
2,739 |
$36K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,368 |
1,191 |
$35K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,176 |
1,148 |
$25K |
| 99000 |
|
4,222 |
4,073 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
680 |
668 |
$8K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
352 |
334 |
$6K |
| 87210 |
|
1,087 |
1,042 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
174 |
160 |
$4K |
| 81025 |
|
302 |
276 |
$2K |
| 86703 |
|
186 |
186 |
$2K |
| J3490 |
Unclassified drugs |
127 |
120 |
$2K |
| 58300 |
|
25 |
25 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
63 |
63 |
$1K |
| 81002 |
|
133 |
132 |
$452.40 |
| 99201 |
|
15 |
15 |
$341.71 |