| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,106 |
2,645 |
$362K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,629 |
1,443 |
$20K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
611 |
329 |
$15K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
206 |
206 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
423 |
399 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
328 |
309 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
429 |
381 |
$3K |
| 90686 |
|
197 |
196 |
$2K |
| 90651 |
|
172 |
171 |
$2K |
| 86580 |
|
373 |
371 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
60 |
60 |
$1K |
| A4267 |
Contraceptive supply, condom, male, each |
433 |
421 |
$787.78 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
256 |
112 |
$483.84 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
33 |
$292.46 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
42 |
39 |
$245.51 |
| 90715 |
|
28 |
28 |
$182.00 |
| 90744 |
|
12 |
12 |
$45.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 1159F |
|
16 |
13 |
$0.00 |
| 2010F |
|
14 |
12 |
$0.00 |
| 90634 |
|
34 |
34 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |