| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0502F |
|
483 |
353 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
247 |
174 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
169 |
108 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
71 |
40 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
84 |
63 |
$4K |
| 87806 |
|
147 |
107 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
94 |
67 |
$911.59 |
| S4993 |
Contraceptive pills for birth control |
27 |
15 |
$906.38 |
| 87210 |
|
164 |
102 |
$761.05 |
| 81025 |
|
233 |
178 |
$673.69 |
| 83986 |
|
161 |
101 |
$562.93 |
| 81002 |
|
139 |
117 |
$325.39 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
15 |
12 |
$254.76 |