| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99401 |
|
489 |
353 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
207 |
179 |
$14K |
| 87806 |
|
431 |
350 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
114 |
81 |
$3K |
| 81025 |
|
524 |
377 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
13 |
$1K |
| 87210 |
|
119 |
88 |
$559.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
39 |
24 |
$382.59 |
| 83986 |
|
107 |
76 |
$376.64 |
| 99070 |
|
14 |
12 |
$224.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
23 |
15 |
$138.03 |