| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99401 |
|
2,008 |
1,460 |
$54K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
937 |
800 |
$49K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
879 |
668 |
$34K |
| 87806 |
|
1,624 |
1,350 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
442 |
391 |
$16K |
| 81025 |
|
1,973 |
1,533 |
$9K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
316 |
258 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
482 |
337 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
40 |
40 |
$4K |
| 87210 |
|
724 |
562 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
44 |
44 |
$3K |
| 83986 |
|
556 |
411 |
$2K |
| S4993 |
Contraceptive pills for birth control |
17 |
14 |
$706.30 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
32 |
27 |
$398.82 |