| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
28,646 |
26,111 |
$2.60M |
| S4993 |
Contraceptive pills for birth control |
15,721 |
10,456 |
$1.13M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,917 |
6,674 |
$396K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,810 |
9,155 |
$344K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
8,578 |
7,098 |
$211K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,722 |
2,641 |
$110K |
| A4267 |
Contraceptive supply, condom, male, each |
8,669 |
8,288 |
$108K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,118 |
1,084 |
$105K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,572 |
1,520 |
$98K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
5,257 |
5,131 |
$91K |
| 87806 |
|
2,941 |
2,859 |
$74K |
| 99000 |
|
16,002 |
15,295 |
$57K |
| 81025 |
|
5,048 |
4,851 |
$42K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,788 |
2,725 |
$40K |
| 87210 |
|
6,364 |
6,117 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,287 |
1,245 |
$33K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,766 |
1,666 |
$32K |
| J3490 |
Unclassified drugs |
1,760 |
1,655 |
$26K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
24 |
24 |
$9K |
| 81002 |
|
1,783 |
1,710 |
$6K |
| 11982 |
|
54 |
53 |
$5K |
| 87563 |
|
113 |
107 |
$3K |
| 58300 |
|
55 |
54 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
36 |
36 |
$816.84 |
| J7297 |
Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg |
13 |
13 |
$700.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
459 |
440 |
$376.82 |