| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
974 |
808 |
$64K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,512 |
1,081 |
$63K |
| 99401 |
|
2,021 |
1,403 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,010 |
759 |
$41K |
| 87806 |
|
996 |
812 |
$19K |
| 81025 |
|
2,762 |
1,923 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
995 |
652 |
$10K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
13 |
12 |
$6K |
| 87210 |
|
572 |
424 |
$3K |
| 83986 |
|
547 |
409 |
$2K |
| 11981 |
|
13 |
12 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
14 |
13 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
28 |
24 |
$286.70 |
| 85018 |
|
28 |
28 |
$57.67 |