| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,202 |
2,397 |
$185K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
86 |
86 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
73 |
$7K |
| 81002 |
|
2,148 |
1,571 |
$6K |
| 81025 |
|
728 |
702 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
54 |
54 |
$5K |
| 59430 |
|
40 |
40 |
$4K |
| 59025 |
Fetal non-stress test |
57 |
39 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
40 |
40 |
$685.78 |
| 85018 |
|
221 |
209 |
$551.42 |
| A4550 |
Surgical trays |
45 |
45 |
$294.75 |
| 87210 |
|
27 |
27 |
$122.58 |
| 82120 |
|
12 |
12 |
$56.04 |
| 81003 |
|
12 |
12 |
$23.28 |