| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
51,767 |
34,433 |
$9.02M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48,473 |
29,164 |
$591K |
| 76830 |
Ultrasound, transvaginal |
2,145 |
1,912 |
$110K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
2,564 |
2,245 |
$104K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,330 |
1,221 |
$72K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,913 |
1,516 |
$55K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
48 |
40 |
$36K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,968 |
1,709 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,300 |
2,742 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
837 |
739 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
630 |
556 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,053 |
981 |
$11K |
| 90686 |
|
234 |
221 |
$7K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
573 |
546 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
272 |
259 |
$4K |
| 90715 |
|
189 |
180 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
24 |
$2K |
| 11981 |
|
13 |
13 |
$1K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
35 |
25 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
30 |
30 |
$957.97 |
| 90656 |
|
39 |
39 |
$601.71 |
| 76536 |
|
13 |
12 |
$491.44 |
| 59025 |
Fetal non-stress test |
41 |
27 |
$283.77 |
| 76810 |
|
17 |
13 |
$105.20 |
| 3074F |
|
811 |
572 |
$0.00 |
| 3008F |
|
279 |
214 |
$0.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
85 |
70 |
$0.00 |
| 90688 |
|
16 |
15 |
$0.00 |
| 3078F |
|
437 |
302 |
$0.00 |
| 11982 |
|
26 |
26 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
13 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
18 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
81 |
79 |
$0.00 |