| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
573 |
573 |
$131K |
| T1028 |
Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs |
668 |
513 |
$99K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
624 |
604 |
$27K |
| T1001 |
Nursing assessment / evaluation |
56 |
56 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
222 |
221 |
$7K |
| G9016 |
Smoking cessation counseling, individual, in the absence of or in addition to any other evaluation and management service, per session (6-10 minutes) [demo project code only] |
393 |
312 |
$7K |
| 99501 |
|
35 |
25 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
388 |
375 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
95 |
95 |
$4K |
| T1015 |
Clinic visit/encounter, all-inclusive |
21 |
17 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
80 |
65 |
$4K |
| A0425 |
Ground mileage, per statute mile |
916 |
648 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
26 |
$2K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
161 |
161 |
$2K |
| 99215 |
Prolong outpt/office vis |
20 |
12 |
$2K |
| 59025 |
Fetal non-stress test |
61 |
54 |
$848.45 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
298 |
293 |
$807.00 |
| 81025 |
|
180 |
175 |
$797.96 |
| 99401 |
|
22 |
21 |
$413.89 |