| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,356 |
4,369 |
$497K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,271 |
2,374 |
$80K |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,660 |
692 |
$33K |
| 90837 |
Psychotherapy, 53 minutes with patient |
201 |
123 |
$4K |
| 87430 |
|
2,101 |
1,277 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
208 |
136 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
30 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
137 |
82 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
116 |
86 |
$791.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
100 |
42 |
$645.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
22 |
12 |
$433.28 |
| 90688 |
|
66 |
49 |
$115.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
511 |
420 |
$98.16 |
| 90674 |
|
100 |
52 |
$85.01 |
| 99173 |
|
58 |
30 |
$43.48 |
| 90734 |
|
87 |
41 |
$40.00 |
| 90651 |
|
70 |
44 |
$35.66 |
| 90715 |
|
77 |
53 |
$35.00 |
| A9150 |
Non-prescription drugs |
26 |
14 |
$0.84 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
65 |
47 |
$0.00 |
| 90686 |
|
205 |
108 |
$0.00 |
| 90733 |
|
57 |
42 |
$0.00 |
| 90656 |
|
116 |
84 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
21 |
12 |
$0.00 |