| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,429 |
4,431 |
$514K |
| H2020 |
Therapeutic behavioral services, per diem |
164 |
146 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,868 |
2,362 |
$2K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
15 |
13 |
$66.67 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
228 |
187 |
$62.65 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$13.13 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17 |
14 |
$9.17 |
| G8484 |
Influenza immunization was not administered, reason not given |
17 |
15 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
57 |
40 |
$0.00 |
| 3078F |
|
13 |
13 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
30 |
$0.00 |
| 3074F |
|
13 |
13 |
$0.00 |