| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,040 |
690 |
$179K |
| H2020 |
Therapeutic behavioral services, per diem |
636 |
235 |
$101K |
| 1159F |
|
286 |
234 |
$0.00 |
| 3078F |
|
649 |
447 |
$0.00 |
| 1160F |
|
291 |
237 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
97 |
83 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
17 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
344 |
247 |
$0.00 |
| 90658 |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
33 |
33 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
41 |
39 |
$0.00 |
| 99173 |
|
18 |
13 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
36 |
16 |
$0.00 |
| 1125F |
|
397 |
319 |
$0.00 |
| 3074F |
|
649 |
447 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
56 |
$0.00 |
| 1126F |
|
318 |
232 |
$0.00 |
| 3008F |
|
995 |
640 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
209 |
162 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
47 |
42 |
$0.00 |
| 90656 |
|
34 |
21 |
$0.00 |
| 90686 |
|
50 |
50 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
18 |
18 |
$0.00 |