| 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 |
Blood count; complete (CBC), automated, and automated differential WBC count |
363 |
222 |
$7.74 |
| 36415 |
Collection of venous blood by venipuncture |
3,246 |
2,499 |
$2.17 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,093 |
4,482 |
$0.71 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
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 |
Psychotherapy, 53 minutes with patient |
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 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
36 |
29 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
38 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
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 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
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 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
36 |
$0.00 |