| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
539 |
490 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
91 |
81 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
28 |
28 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
47 |
40 |
$1K |
| 76830 |
Ultrasound, transvaginal |
31 |
25 |
$994.61 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$107.91 |