| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
731 |
729 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
700 |
692 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
27 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
78 |
78 |
$761.58 |
| 81025 |
|
66 |
63 |
$439.14 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
41 |
$287.00 |
| 87210 |
|
15 |
14 |
$70.86 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
26 |
26 |
$0.00 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
26 |
26 |
$0.00 |