| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
90 |
84 |
$858.24 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
215 |
208 |
$750.06 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
128 |
127 |
$525.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
128 |
127 |
$525.00 |
| S4993 |
Contraceptive pills for birth control |
16 |
14 |
$447.75 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
14 |
$28.35 |
| 87210 |
|
37 |
35 |
$4.70 |
| 99401 |
|
440 |
401 |
$0.00 |
| 81025 |
|
28 |
26 |
$0.00 |