| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
563 |
524 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
310 |
297 |
$20K |
| S0612 |
Annual gynecological examination, established patient |
129 |
129 |
$8K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
140 |
134 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
155 |
147 |
$2K |
| 81025 |
|
452 |
431 |
$2K |
| 76801 |
|
38 |
37 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
19 |
19 |
$813.04 |
| 11976 |
|
12 |
12 |
$670.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
70 |
$629.10 |
| 3078F |
|
377 |
304 |
$3.77 |
| 1036F |
|
90 |
81 |
$0.90 |
| 3079F |
|
14 |
12 |
$0.14 |