| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
55,500 |
48,915 |
$3.58M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,521 |
19,283 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,206 |
12,554 |
$57K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
760 |
755 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,848 |
4,833 |
$34K |
| 59426 |
|
24 |
24 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,304 |
4,242 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,704 |
3,692 |
$14K |
| 90651 |
|
1,635 |
1,628 |
$12K |
| 90715 |
|
1,125 |
1,121 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,281 |
2,279 |
$8K |
| 90677 |
|
654 |
654 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,485 |
1,454 |
$6K |
| 90686 |
|
4,723 |
4,712 |
$6K |
| 99215 |
Prolong outpt/office vis |
681 |
675 |
$5K |
| 99381 |
|
722 |
713 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
558 |
557 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13,593 |
13,483 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
643 |
641 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,120 |
7,057 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
445 |
445 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,488 |
1,465 |
$2K |
| 98966 |
|
678 |
622 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
582 |
577 |
$2K |
| 90670 |
|
2,963 |
2,951 |
$2K |
| 90480 |
|
138 |
138 |
$1K |
| 0002A |
|
44 |
44 |
$1K |
| 0001A |
|
84 |
83 |
$1K |
| 91320 |
|
69 |
69 |
$743.90 |
| 0124A |
|
138 |
127 |
$731.29 |
| 0054A |
|
102 |
102 |
$675.87 |
| 0071A |
|
45 |
45 |
$641.92 |
| 90656 |
|
296 |
295 |
$579.10 |
| G9002 |
Coordinated care fee, maintenance rate |
30 |
30 |
$525.73 |
| 90620 |
|
212 |
212 |
$360.48 |
| 90716 |
|
1,418 |
1,413 |
$285.60 |
| 90707 |
|
1,404 |
1,399 |
$231.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,852 |
4,841 |
$217.97 |
| 99442 |
|
45 |
42 |
$216.30 |
| D0190 |
|
664 |
662 |
$208.91 |
| 99188 |
|
1,780 |
1,778 |
$181.74 |
| 90474 |
|
2,317 |
2,307 |
$173.50 |
| 99443 |
|
16 |
16 |
$135.48 |
| 59025 |
Fetal non-stress test |
124 |
54 |
$112.52 |
| 99441 |
|
40 |
39 |
$110.88 |
| 98967 |
|
15 |
15 |
$53.67 |
| 96127 |
|
2,014 |
1,973 |
$29.91 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$16.18 |
| 96381 |
|
44 |
43 |
$16.15 |
| 99174 |
|
552 |
552 |
$8.10 |
| 92551 |
|
50 |
50 |
$6.55 |
| 96161 |
|
562 |
536 |
$0.49 |
| 36416 |
|
1,404 |
1,382 |
$0.49 |
| 0081A |
|
13 |
13 |
$0.07 |
| 36415 |
Collection of venous blood by venipuncture |
62 |
62 |
$0.06 |
| 90619 |
|
372 |
372 |
$0.06 |
| 90734 |
|
594 |
590 |
$0.02 |
| 90680 |
|
2,354 |
2,344 |
$0.01 |
| 90744 |
|
1,213 |
1,205 |
$0.01 |
| 90697 |
|
1,016 |
1,015 |
$0.01 |
| 90633 |
|
1,846 |
1,839 |
$0.00 |
| 90685 |
|
700 |
693 |
$0.00 |
| 99173 |
|
1,877 |
1,877 |
$0.00 |
| 90713 |
|
180 |
180 |
$0.00 |
| 90700 |
|
915 |
909 |
$0.00 |
| 90710 |
|
95 |
95 |
$0.00 |
| 0121A |
|
14 |
14 |
$0.00 |
| 90647 |
|
329 |
328 |
$0.00 |
| 90698 |
|
1,726 |
1,718 |
$0.00 |
| 90381 |
|
23 |
23 |
$0.00 |
| 90696 |
|
243 |
243 |
$0.00 |
| 99383 |
|
92 |
92 |
$0.00 |