| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
304 |
259 |
$14K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
247 |
182 |
$12K |
| 87806 |
|
422 |
351 |
$8K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
23 |
13 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
231 |
169 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
408 |
308 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
49 |
27 |
$3K |
| 81025 |
|
736 |
526 |
$2K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
140 |
104 |
$2K |
| S4993 |
Contraceptive pills for birth control |
53 |
48 |
$2K |
| 87210 |
|
257 |
221 |
$1K |
| 83986 |
|
255 |
219 |
$888.41 |
| 99401 |
|
15 |
15 |
$360.00 |
| 86901 |
|
19 |
12 |
$65.80 |
| 85018 |
|
27 |
14 |
$53.36 |
| S0190 |
Mifepristone, oral, 200 mg |
17 |
15 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
18 |
16 |
$0.00 |