| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
505 |
368 |
$31K |
| 99401 |
|
1,014 |
732 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
418 |
307 |
$18K |
| 87806 |
|
489 |
354 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
482 |
362 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
146 |
110 |
$4K |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
152 |
107 |
$4K |
| 81025 |
|
881 |
603 |
$3K |
| 87210 |
|
401 |
261 |
$2K |
| 83986 |
|
402 |
262 |
$1K |
| S4993 |
Contraceptive pills for birth control |
20 |
16 |
$867.74 |