| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,067 |
1,840 |
$71K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
235 |
235 |
$5K |
| 59025 |
Fetal non-stress test |
31 |
24 |
$421.80 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
15 |
$232.97 |
| 81025 |
|
45 |
40 |
$167.20 |
| 3725F |
|
497 |
495 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
514 |
511 |
$0.00 |