| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,557 |
4,423 |
$802K |
| 0124A |
|
167 |
159 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
220 |
118 |
$4K |
| 90686 |
|
488 |
396 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
743 |
403 |
$2K |
| 0012A |
|
13 |
13 |
$547.82 |
| 81025 |
|
1,066 |
646 |
$445.09 |
| 90480 |
|
27 |
27 |
$413.25 |
| 90715 |
|
63 |
38 |
$272.91 |
| 0011A |
|
13 |
13 |
$220.22 |
| 90670 |
|
202 |
132 |
$57.60 |
| 90651 |
|
68 |
53 |
$51.20 |
| 90744 |
|
51 |
36 |
$38.40 |
| 90633 |
|
68 |
53 |
$19.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
964 |
667 |
$16.07 |
| 90696 |
|
18 |
12 |
$12.80 |
| 90710 |
|
18 |
12 |
$12.80 |
| 90734 |
|
49 |
29 |
$6.40 |
| 90700 |
|
32 |
12 |
$6.40 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
98 |
53 |
$6.30 |
| 82962 |
|
377 |
138 |
$1.68 |
| 3008F |
|
3,607 |
2,170 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,793 |
1,305 |
$0.00 |
| 2015F |
|
458 |
266 |
$0.00 |
| 96127 |
|
2,953 |
1,241 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,022 |
1,705 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,651 |
922 |
$0.00 |
| 90698 |
|
47 |
29 |
$0.00 |
| 94200 |
|
366 |
191 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,070 |
734 |
$0.00 |
| S5190 |
Wellness assessment, performed by non-physician |
179 |
151 |
$0.00 |
| 36416 |
|
637 |
194 |
$0.00 |
| 3074F |
|
114 |
42 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
24 |
$0.00 |
| 3079F |
|
34 |
14 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,919 |
1,068 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
517 |
359 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
882 |
628 |
$0.00 |
| H0050 |
Alcohol and/or drug services, brief intervention, per 15 minutes |
792 |
247 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
194 |
129 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
315 |
129 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
466 |
319 |
$0.00 |
| 0502F |
|
172 |
55 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
360 |
247 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
383 |
171 |
$0.00 |
| 81002 |
|
442 |
165 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
145 |
53 |
$0.00 |
| 90756 |
|
46 |
13 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
38 |
13 |
$0.00 |