| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
319 |
280 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
85 |
85 |
$5K |
| 76830 |
Ultrasound, transvaginal |
47 |
47 |
$3K |
| 99215 |
Prolong outpt/office vis |
32 |
26 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
36 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$823.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$358.21 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$0.19 |