| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,017 |
14,094 |
$4.02M |
| 3044F |
|
1,187 |
916 |
$30.00 |
| 81025 |
|
4,794 |
2,756 |
$12.62 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
718 |
492 |
$0.00 |
| 1160F |
|
5,524 |
4,142 |
$0.00 |
| 3078F |
|
10,294 |
7,081 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,859 |
1,458 |
$0.00 |
| 1159F |
|
11,216 |
8,164 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
265 |
227 |
$0.00 |
| 3725F |
|
2,009 |
1,095 |
$0.00 |
| 81002 |
|
1,003 |
478 |
$0.00 |
| 87220 |
|
120 |
78 |
$0.00 |
| 87210 |
|
222 |
138 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
930 |
664 |
$0.00 |
| 59025 |
Fetal non-stress test |
576 |
210 |
$0.00 |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
53 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
323 |
263 |
$0.00 |
| 81003 |
|
473 |
301 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
13 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
72 |
24 |
$0.00 |
| 3008F |
|
12,330 |
8,472 |
$0.00 |
| 1034F |
|
522 |
309 |
$0.00 |
| J3490 |
Unclassified drugs |
472 |
365 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,977 |
3,426 |
$0.00 |
| 3075F |
|
768 |
584 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,392 |
5,738 |
$0.00 |
| 3074F |
|
10,896 |
7,511 |
$0.00 |
| 99385 |
|
223 |
181 |
$0.00 |
| 4010F |
|
306 |
240 |
$0.00 |
| 3079F |
|
1,599 |
1,218 |
$0.00 |
| 1036F |
|
1,629 |
854 |
$0.00 |
| 59430 |
|
104 |
39 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
181 |
126 |
$0.00 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
859 |
579 |
$0.00 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
171 |
72 |
$0.00 |
| 1031F |
|
41 |
26 |
$0.00 |
| 1126F |
|
1,775 |
977 |
$0.00 |
| 76801 |
|
244 |
146 |
$0.00 |
| 90686 |
|
42 |
38 |
$0.00 |