| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,686 |
1,625 |
$127K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
43 |
38 |
$53K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,442 |
2,266 |
$35K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
187 |
160 |
$11K |
| 58300 |
|
74 |
65 |
$4K |
| 11981 |
|
43 |
38 |
$3K |
| J2788 |
Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.) |
98 |
96 |
$2K |
| 90385 |
|
28 |
28 |
$987.76 |
| 81025 |
|
169 |
162 |
$913.86 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$451.36 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
41 |
38 |
$187.11 |
| 85018 |
|
12 |
12 |
$5.34 |