| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,090 |
1,074 |
$13K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
879 |
879 |
$5K |
| D0190 |
|
246 |
244 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
435 |
433 |
$4K |
| 36416 |
|
389 |
389 |
$3K |
| S4993 |
Contraceptive pills for birth control |
492 |
475 |
$2K |
| 99188 |
|
246 |
244 |
$2K |
| 90686 |
|
154 |
154 |
$1K |
| 91322 |
|
12 |
12 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
60 |
60 |
$979.00 |
| 81025 |
|
72 |
70 |
$506.23 |
| 90656 |
|
18 |
18 |
$157.12 |
| 90480 |
|
12 |
12 |
$156.00 |
| A4267 |
Contraceptive supply, condom, male, each |
579 |
561 |
$119.52 |
| 87270 |
|
27 |
27 |
$0.00 |
| 87081 |
|
27 |
27 |
$0.00 |