| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H1010 |
Non-medical family planning education, per session |
12,238 |
11,136 |
$1.10M |
| S4993 |
Contraceptive pills for birth control |
7,686 |
4,754 |
$553K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,469 |
3,246 |
$105K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,052 |
1,939 |
$95K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,023 |
1,692 |
$53K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
879 |
839 |
$48K |
| A4267 |
Contraceptive supply, condom, male, each |
3,847 |
3,658 |
$47K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
2,590 |
2,502 |
$46K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,341 |
1,296 |
$44K |
| 87806 |
|
1,520 |
1,464 |
$38K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
478 |
443 |
$37K |
| 99000 |
|
6,190 |
5,843 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,653 |
1,591 |
$20K |
| 81025 |
|
1,829 |
1,740 |
$15K |
| 87210 |
|
1,981 |
1,867 |
$11K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
25 |
24 |
$10K |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
522 |
487 |
$9K |
| 90651 |
|
45 |
42 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
305 |
296 |
$7K |
| Q3014 |
Telehealth originating site facility fee |
170 |
169 |
$4K |
| 87563 |
|
64 |
60 |
$2K |
| 81002 |
|
339 |
321 |
$1K |
| 86703 |
|
91 |
71 |
$816.00 |
| 58300 |
|
14 |
14 |
$475.44 |