| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99401 |
|
2,391 |
1,802 |
$61K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
514 |
342 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
365 |
298 |
$14K |
| 87806 |
|
623 |
511 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
441 |
289 |
$4K |
| 81025 |
|
1,031 |
749 |
$3K |
| 87210 |
|
527 |
431 |
$2K |
| 83986 |
|
525 |
430 |
$2K |
| S4993 |
Contraceptive pills for birth control |
41 |
37 |
$1K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
23 |
23 |
$916.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
12 |
$862.80 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
51 |
29 |
$851.38 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
28 |
$754.47 |