| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
14,750 |
9,314 |
$1.92M |
| H2020 |
Therapeutic behavioral services, per diem |
3,591 |
2,156 |
$460K |
| 0001A |
|
52 |
24 |
$84.16 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
2,253 |
1,580 |
$51.24 |
| 99177 |
|
1,655 |
1,284 |
$41.12 |
| 0002A |
|
41 |
16 |
$37.08 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,743 |
3,196 |
$23.83 |
| 99188 |
|
1,236 |
816 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,042 |
868 |
$0.00 |
| 81003 |
|
415 |
308 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
2,313 |
1,782 |
$0.00 |
| 96160 |
|
248 |
163 |
$0.00 |
| 1159F |
|
2,125 |
1,531 |
$0.00 |
| 3078F |
|
3,285 |
2,410 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
145 |
107 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
879 |
362 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
2,481 |
1,211 |
$0.00 |
| 1160F |
|
2,121 |
1,531 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
786 |
694 |
$0.00 |
| 90734 |
|
81 |
70 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
400 |
278 |
$0.00 |
| 91300 |
|
96 |
24 |
$0.00 |
| 90461 |
|
110 |
61 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
17 |
$0.00 |
| 99173 |
|
18 |
15 |
$0.00 |
| 90715 |
|
64 |
57 |
$0.00 |
| 90633 |
|
42 |
28 |
$0.00 |
| 90649 |
|
28 |
21 |
$0.00 |
| 92551 |
|
1,520 |
1,269 |
$0.00 |
| 1125F |
|
2,400 |
1,842 |
$0.00 |
| 85018 |
|
1,766 |
1,322 |
$0.00 |
| 90686 |
|
58 |
49 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
888 |
680 |
$0.00 |
| 3008F |
|
5,537 |
3,943 |
$0.00 |
| 3074F |
|
3,296 |
2,417 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,158 |
4,581 |
$0.00 |
| 96127 |
|
1,591 |
1,156 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
22 |
18 |
$0.00 |
| 1126F |
|
960 |
841 |
$0.00 |
| 90651 |
|
138 |
114 |
$0.00 |
| 1036F |
|
459 |
324 |
$0.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
14 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
30 |
30 |
$0.00 |
| 96161 |
|
134 |
73 |
$0.00 |
| J3490 |
Unclassified drugs |
31 |
27 |
$0.00 |
| 99000 |
|
423 |
289 |
$0.00 |
| 91307 |
|
33 |
12 |
$0.00 |
| A9150 |
Non-prescription drugs |
83 |
52 |
$0.00 |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
13 |
13 |
$0.00 |