| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
34,554 |
23,678 |
$5.19M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,972 |
5,047 |
$112K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,323 |
1,222 |
$23K |
| 59425 |
|
399 |
334 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
996 |
885 |
$11K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
31 |
26 |
$11K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
541 |
413 |
$7K |
| J3490 |
Unclassified drugs |
459 |
411 |
$6K |
| 99000 |
|
5,713 |
5,103 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
621 |
554 |
$1K |
| 81003 |
|
7,302 |
5,362 |
$915.74 |
| 81025 |
|
1,767 |
1,603 |
$816.33 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176 |
169 |
$776.34 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
69 |
62 |
$453.17 |
| 90715 |
|
433 |
426 |
$154.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
659 |
638 |
$70.72 |
| 85018 |
|
440 |
404 |
$41.82 |
| Z6410 |
|
1,423 |
1,167 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,580 |
1,497 |
$0.00 |
| Z1032 |
|
714 |
712 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,844 |
4,775 |
$0.00 |
| Z1038 |
|
577 |
554 |
$0.00 |
| Z1034 |
|
7,760 |
5,452 |
$0.00 |
| 90686 |
|
169 |
168 |
$0.00 |
| Z6204 |
|
173 |
162 |
$0.00 |
| Z6404 |
|
210 |
207 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
85 |
67 |
$0.00 |
| 1220F |
|
155 |
146 |
$0.00 |
| Z6406 |
|
92 |
81 |
$0.00 |
| 81000 |
|
18 |
17 |
$0.00 |
| 96160 |
|
291 |
250 |
$0.00 |
| Z6500 |
|
232 |
231 |
$0.00 |
| Z6400 |
|
603 |
600 |
$0.00 |
| Z6414 |
|
172 |
170 |
$0.00 |
| 81002 |
|
55 |
53 |
$0.00 |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
46 |
46 |
$0.00 |
| Z6208 |
|
13 |
12 |
$0.00 |