| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S4993 |
Contraceptive pills for birth control |
94 |
76 |
$6K |
| H1010 |
Non-medical family planning education, per session |
105 |
94 |
$5K |
| A4267 |
Contraceptive supply, condom, male, each |
71 |
56 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
59 |
56 |
$701.01 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
12 |
$249.71 |
| 99000 |
|
56 |
40 |
$153.34 |
| A4268 |
Contraceptive supply, condom, female, each |
16 |
12 |
$82.56 |