| Code | Description | Claims | Beneficiaries | Total Paid |
| T1015 |
Clinic visit/encounter, all-inclusive |
49,524 |
31,558 |
$3.53M |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38,868 |
20,327 |
$700K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,388 |
11,421 |
$402K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,931 |
2,190 |
$117K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
2,675 |
1,587 |
$77K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
1,783 |
1,075 |
$75K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
1,603 |
974 |
$65K |
| 76830 |
Ultrasound, transvaginal |
1,569 |
938 |
$48K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
1,499 |
885 |
$42K |
| 76801 |
|
1,423 |
792 |
$38K |
| H1000 |
Prenatal care, at-risk assessment |
923 |
499 |
$34K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
1,104 |
683 |
$29K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,130 |
1,855 |
$18K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
217 |
133 |
$7K |
| 59025 |
Fetal non-stress test |
402 |
227 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
327 |
199 |
$7K |
| 59430 |
|
36 |
35 |
$4K |
| 90715 |
|
253 |
151 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
463 |
267 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
154 |
111 |
$2K |
| 81025 |
|
291 |
187 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
61 |
27 |
$443.62 |
| 90686 |
|
25 |
13 |
$216.46 |
| 81002 |
|
132 |
71 |
$127.61 |
| 87210 |
|
21 |
13 |
$44.80 |
| 1036F |
|
73 |
72 |
$0.00 |
| 0500F |
|
461 |
313 |
$0.00 |
| 0503F |
|
30 |
30 |
$0.00 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
26 |
12 |
$0.00 |
| 0502F |
|
5,350 |
3,140 |
$0.00 |
| 1160F |
|
1,808 |
996 |
$0.00 |
| 1159F |
|
24 |
12 |
$0.00 |