| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,673 |
4,890 |
$537K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,316 |
3,831 |
$167K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,794 |
1,223 |
$30K |
| 59430 |
|
335 |
186 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
340 |
234 |
$9K |
| 76801 |
|
354 |
166 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
292 |
193 |
$6K |
| 81003 |
|
3,377 |
2,576 |
$4K |
| 81025 |
|
1,002 |
653 |
$3K |
| 81002 |
|
4,874 |
1,524 |
$2K |
| 90715 |
|
79 |
75 |
$2K |
| 99404 |
|
76 |
29 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
186 |
171 |
$2K |
| 96160 |
|
1,290 |
479 |
$730.53 |
| 90686 |
|
45 |
40 |
$685.85 |
| 90656 |
|
51 |
49 |
$674.69 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
18 |
16 |
$662.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
38 |
16 |
$257.08 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
13 |
$80.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$79.10 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
14 |
$67.70 |
| 82962 |
|
34 |
28 |
$49.34 |
| 1036F |
|
3,707 |
2,908 |
$0.02 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
3,569 |
1,146 |
$0.00 |
| 0503F |
|
69 |
40 |
$0.00 |
| 0500F |
|
310 |
125 |
$0.00 |
| 4004F |
|
1,024 |
399 |
$0.00 |