| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99401 |
|
2,025 |
1,607 |
$55K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
757 |
564 |
$34K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
306 |
269 |
$22K |
| 87806 |
|
406 |
330 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
748 |
505 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
118 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59 |
50 |
$4K |
| 81025 |
|
1,121 |
802 |
$3K |
| S4993 |
Contraceptive pills for birth control |
69 |
62 |
$3K |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$1K |
| 85018 |
|
286 |
238 |
$640.32 |
| 86901 |
|
101 |
100 |
$470.00 |
| A4267 |
Contraceptive supply, condom, male, each |
15 |
12 |
$233.94 |
| 87210 |
|
22 |
17 |
$103.40 |
| 83986 |
|
22 |
17 |
$77.44 |