| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
78,407 |
68,022 |
$4.42M |
| 59426 |
|
1,292 |
1,267 |
$1.15M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34,652 |
31,870 |
$220K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16,672 |
15,636 |
$170K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,645 |
1,636 |
$85K |
| 59430 |
|
1,072 |
1,066 |
$77K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,746 |
3,731 |
$63K |
| 90670 |
|
2,160 |
2,143 |
$50K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,011 |
3,846 |
$49K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,646 |
2,627 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
3,894 |
3,858 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,470 |
5,439 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,520 |
1,520 |
$23K |
| 90715 |
|
1,269 |
1,261 |
$23K |
| 90686 |
|
2,986 |
2,973 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,234 |
1,221 |
$19K |
| 90671 |
|
871 |
871 |
$18K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,041 |
1,027 |
$14K |
| 90739 |
|
105 |
105 |
$12K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,080 |
2,900 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,206 |
4,140 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,979 |
3,928 |
$7K |
| 90651 |
|
106 |
106 |
$6K |
| 99381 |
|
448 |
447 |
$6K |
| 81025 |
|
3,977 |
3,815 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
449 |
445 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
192 |
192 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
231 |
226 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,162 |
1,083 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
4,003 |
3,728 |
$3K |
| 99215 |
Prolong outpt/office vis |
107 |
104 |
$3K |
| 59025 |
Fetal non-stress test |
584 |
299 |
$2K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
513 |
505 |
$2K |
| 90480 |
|
61 |
61 |
$2K |
| 58300 |
|
106 |
105 |
$2K |
| 90746 |
|
30 |
30 |
$2K |
| 80305 |
|
1,490 |
1,278 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
726 |
719 |
$2K |
| 91322 |
|
12 |
12 |
$2K |
| 90716 |
|
178 |
178 |
$1K |
| 90707 |
|
159 |
159 |
$1K |
| 87428 |
|
396 |
393 |
$1K |
| 58301 |
|
37 |
37 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
517 |
508 |
$1K |
| 0054A |
|
32 |
32 |
$938.25 |
| 90656 |
|
172 |
172 |
$916.35 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
426 |
261 |
$902.74 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
571 |
571 |
$901.09 |
| 81003 |
|
2,959 |
2,890 |
$858.42 |
| 99188 |
|
492 |
492 |
$706.36 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
28 |
28 |
$599.67 |
| 0004A |
|
16 |
16 |
$567.75 |
| 90837 |
Psychotherapy, 53 minutes with patient |
41 |
25 |
$432.85 |
| 0002A |
|
12 |
12 |
$416.35 |
| 99385 |
|
16 |
16 |
$397.48 |
| 87807 |
|
175 |
174 |
$368.90 |
| 98966 |
|
45 |
37 |
$362.60 |
| 96127 |
|
518 |
354 |
$337.94 |
| 0124A |
|
84 |
82 |
$237.59 |
| 90750 |
|
12 |
12 |
$148.40 |
| 90474 |
|
68 |
68 |
$117.89 |
| 99406 |
|
39 |
39 |
$64.96 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
76 |
68 |
$54.34 |
| 90834 |
Psychotherapy, 45 minutes with patient |
29 |
12 |
$48.73 |
| 85018 |
|
71 |
71 |
$47.04 |
| 96161 |
|
13 |
13 |
$1.45 |
| 90685 |
|
262 |
251 |
$0.00 |
| 90648 |
|
1,564 |
1,562 |
$0.00 |
| 90633 |
|
1,219 |
1,216 |
$0.00 |
| 90710 |
|
55 |
55 |
$0.00 |
| 90461 |
|
3,717 |
3,695 |
$0.00 |
| 90700 |
|
175 |
174 |
$0.00 |
| 91300 |
|
81 |
78 |
$0.00 |
| 90680 |
|
1,884 |
1,866 |
$0.00 |
| 36416 |
|
1,321 |
1,306 |
$0.00 |
| 90723 |
|
1,068 |
1,068 |
$0.00 |
| 90698 |
|
1,097 |
1,077 |
$0.00 |
| 90744 |
|
690 |
678 |
$0.00 |
| 90696 |
|
74 |
74 |
$0.00 |
| 90732 |
|
13 |
12 |
$0.00 |