| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,467 |
4,695 |
$766K |
| H2020 |
Therapeutic behavioral services, per diem |
44 |
37 |
$8K |
| 99051 |
|
87 |
71 |
$522.06 |
| 3074F |
|
2,590 |
2,044 |
$147.23 |
| 1125F |
|
1,590 |
1,277 |
$146.51 |
| 3078F |
|
2,344 |
1,833 |
$107.24 |
| 3079F |
|
793 |
653 |
$55.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,270 |
1,782 |
$33.22 |
| 3075F |
|
156 |
142 |
$5.00 |
| 3077F |
|
80 |
63 |
$5.00 |
| 2001F |
|
2,035 |
1,400 |
$0.00 |
| 1126F |
|
2,008 |
1,603 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,015 |
1,660 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
404 |
314 |
$0.00 |
| 82962 |
|
301 |
200 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,713 |
1,330 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
860 |
579 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
29 |
24 |
$0.00 |
| 2000F |
|
2,035 |
1,393 |
$0.00 |
| 90686 |
|
358 |
305 |
$0.00 |
| 3008F |
|
2,369 |
1,773 |
$0.00 |
| 2010F |
|
1,997 |
1,380 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
138 |
87 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
53 |
40 |
$0.00 |
| 3080F |
|
19 |
14 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
123 |
95 |
$0.00 |
| 1160F |
|
2,715 |
2,186 |
$0.00 |
| 1159F |
|
2,720 |
2,197 |
$0.00 |
| 1003F |
|
1,699 |
1,138 |
$0.00 |
| 3288F |
|
337 |
298 |
$0.00 |
| 81003 |
|
266 |
200 |
$0.00 |
| 3725F |
|
402 |
364 |
$0.00 |
| 1158F |
|
197 |
146 |
$0.00 |
| 96160 |
|
13 |
12 |
$0.00 |
| 90715 |
|
45 |
32 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
71 |
64 |
$0.00 |
| 81025 |
|
53 |
12 |
$0.00 |
| 86703 |
|
101 |
47 |
$0.00 |
| 90714 |
|
14 |
12 |
$0.00 |