| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,539 |
6,057 |
$1.29M |
| H2020 |
Therapeutic behavioral services, per diem |
1,517 |
977 |
$189K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,740 |
2,185 |
$338.00 |
| 0012A |
|
65 |
17 |
$333.72 |
| 0011A |
|
83 |
28 |
$322.84 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,021 |
854 |
$298.80 |
| 0001A |
|
25 |
13 |
$259.56 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
1,792 |
829 |
$117.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,406 |
3,002 |
$24.83 |
| 92551 |
|
1,356 |
1,180 |
$23.73 |
| J3490 |
Unclassified drugs |
143 |
108 |
$10.80 |
| 99173 |
|
1,449 |
1,216 |
$5.73 |
| 85018 |
|
1,916 |
1,293 |
$2.36 |
| 96127 |
|
6,981 |
4,699 |
$1.00 |
| 3008F |
|
8,111 |
5,224 |
$0.00 |
| 1000F |
|
3,271 |
2,199 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
4,143 |
2,933 |
$0.00 |
| 1125F |
|
2,655 |
1,855 |
$0.00 |
| 3074F |
|
3,443 |
2,314 |
$0.00 |
| Q0162 |
Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen |
16 |
13 |
$0.00 |
| 1036F |
|
6,507 |
4,312 |
$0.00 |
| 99000 |
|
870 |
636 |
$0.00 |
| 1126F |
|
842 |
718 |
$0.00 |
| 99384 |
|
126 |
106 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
136 |
115 |
$0.00 |
| 91301 |
|
148 |
45 |
$0.00 |
| 90651 |
|
177 |
150 |
$0.00 |
| 90686 |
|
158 |
139 |
$0.00 |
| 96161 |
|
486 |
268 |
$0.00 |
| H0033 |
Oral medication administration, direct observation |
107 |
87 |
$0.00 |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
34 |
29 |
$0.00 |
| A9150 |
Non-prescription drugs |
83 |
52 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
938 |
378 |
$0.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
1,212 |
848 |
$0.00 |
| 1160F |
|
2,188 |
1,481 |
$0.00 |
| 99188 |
|
938 |
630 |
$0.00 |
| 81002 |
|
1,563 |
958 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
845 |
613 |
$0.00 |
| 3078F |
|
3,438 |
2,311 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
967 |
814 |
$0.00 |
| 1159F |
|
2,197 |
1,487 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
115 |
101 |
$0.00 |
| A9273 |
Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type |
80 |
69 |
$0.00 |
| 90461 |
|
68 |
31 |
$0.00 |
| 96160 |
|
439 |
356 |
$0.00 |
| 90734 |
|
117 |
101 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
55 |
44 |
$0.00 |
| 86703 |
|
95 |
63 |
$0.00 |
| 91300 |
|
27 |
14 |
$0.00 |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
142 |
54 |
$0.00 |
| 90715 |
|
15 |
14 |
$0.00 |
| 90633 |
|
56 |
43 |
$0.00 |