| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,743 |
1,531 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
982 |
885 |
$93K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
90 |
87 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
28 |
$3K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$986.85 |
| 90756 |
|
18 |
18 |
$696.83 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |