| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,012 |
2,350 |
$192K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,859 |
1,391 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
597 |
320 |
$19K |
| 99384 |
|
315 |
188 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
180 |
93 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
419 |
203 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
132 |
60 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
239 |
117 |
$3K |
| 96127 |
|
1,020 |
552 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
103 |
46 |
$585.72 |
| 99173 |
|
639 |
359 |
$549.36 |
| 86580 |
|
127 |
60 |
$501.59 |
| 86703 |
|
88 |
41 |
$405.00 |
| 81025 |
|
136 |
58 |
$368.90 |
| 90734 |
|
47 |
28 |
$0.03 |
| 90686 |
|
29 |
23 |
$0.01 |
| 90651 |
|
27 |
14 |
$0.01 |
| 3074F |
|
1,768 |
907 |
$0.00 |
| 3079F |
|
589 |
301 |
$0.00 |
| 3008F |
|
1,987 |
1,097 |
$0.00 |
| 3075F |
|
160 |
92 |
$0.00 |
| 2001F |
|
628 |
349 |
$0.00 |
| 92551 |
|
187 |
108 |
$0.00 |
| 1036F |
|
2,058 |
1,038 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
418 |
240 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
426 |
339 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
17 |
12 |
$0.00 |
| 3080F |
|
31 |
16 |
$0.00 |
| 3078F |
|
1,286 |
679 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
42 |
29 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
435 |
249 |
$0.00 |
| 3077F |
|
53 |
24 |
$0.00 |