| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,592 |
6,142 |
$894K |
| 99214 |
|
3,916 |
2,949 |
$5K |
| 99213 |
|
3,347 |
2,636 |
$3K |
| 87426 |
|
1,769 |
1,410 |
$1K |
| 87804 |
|
1,558 |
1,277 |
$1K |
| 87880 |
|
1,131 |
957 |
$536.64 |
| 96372 |
|
1,190 |
790 |
$464.12 |
| 87428 |
|
214 |
166 |
$228.90 |
| 99203 |
|
20 |
14 |
$95.42 |
| 99393 |
|
43 |
33 |
$64.31 |
| 99212 |
|
288 |
195 |
$57.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
801 |
565 |
$7.36 |
| 81025 |
|
35 |
25 |
$2.60 |
| 81003 |
|
135 |
99 |
$2.30 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
48 |
25 |
$1.88 |
| G8422 |
Bmi not documented, documentation the patient is not eligible for bmi calculation |
32 |
30 |
$0.00 |
| 3074F |
|
41 |
22 |
$0.00 |
| 3351F |
|
134 |
116 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
12 |
12 |
$0.00 |
| 90656 |
|
17 |
17 |
$0.00 |
| 87807 |
|
32 |
15 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
22 |
17 |
$0.00 |
| G8421 |
Bmi not documented and no reason is given |
118 |
113 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 3078F |
|
30 |
16 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
19 |
13 |
$0.00 |
| 99394 |
|
16 |
16 |
$0.00 |
| 1159F |
|
24 |
22 |
$0.00 |