| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,710 |
6,854 |
$1.05M |
| H2020 |
Therapeutic behavioral services, per diem |
379 |
148 |
$38K |
| 3078F |
|
4,485 |
3,377 |
$130.00 |
| 3074F |
|
5,119 |
3,781 |
$130.00 |
| 3079F |
|
1,429 |
1,080 |
$30.00 |
| 85025 |
|
363 |
222 |
$7.74 |
| 36415 |
|
3,246 |
2,499 |
$2.17 |
| 99213 |
|
6,093 |
4,482 |
$0.71 |
| 96372 |
|
3,154 |
1,956 |
$0.02 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,171 |
1,525 |
$0.00 |
| 1160F |
|
441 |
347 |
$0.00 |
| 90837 |
|
275 |
104 |
$0.00 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
854 |
619 |
$0.00 |
| 1159F |
|
445 |
349 |
$0.00 |
| 99396 |
|
36 |
29 |
$0.00 |
| 99395 |
|
49 |
38 |
$0.00 |
| 99393 |
|
13 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
321 |
236 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
511 |
344 |
$0.00 |
| 99214 |
|
2,243 |
1,688 |
$0.00 |
| 3075F |
|
583 |
460 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
909 |
621 |
$0.00 |
| 1036F |
|
458 |
156 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
110 |
78 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
364 |
128 |
$0.00 |
| 90471 |
|
45 |
36 |
$0.00 |