| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
16 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
46 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$709.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
32 |
32 |
$433.07 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
30 |
30 |
$0.00 |