| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,868 |
21,001 |
$3.79M |
| G0008 |
Administration of influenza virus vaccine |
1,890 |
1,874 |
$15K |
| G0009 |
Administration of pneumococcal vaccine |
2,212 |
2,175 |
$14K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
454 |
410 |
$12K |
| 99443 |
|
145 |
137 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,845 |
4,654 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,743 |
6,189 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,968 |
4,603 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,498 |
3,928 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,637 |
3,592 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,977 |
1,965 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
240 |
230 |
$969.33 |
| 99442 |
|
14 |
13 |
$755.02 |
| 90670 |
|
2,543 |
2,497 |
$608.52 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
579 |
576 |
$470.65 |
| 90677 |
|
232 |
229 |
$446.42 |
| 90698 |
|
2,260 |
2,220 |
$400.18 |
| 90474 |
|
616 |
608 |
$176.81 |
| 90633 |
|
1,500 |
1,485 |
$173.10 |
| D1206 |
Topical application of fluoride varnish |
34 |
32 |
$154.59 |
| 90744 |
|
1,028 |
1,007 |
$151.71 |
| 90707 |
|
327 |
326 |
$149.59 |
| G0010 |
Administration of hepatitis b vaccine |
475 |
465 |
$149.47 |
| 83655 |
|
821 |
806 |
$126.83 |
| 90681 |
|
1,019 |
1,002 |
$72.99 |
| 90697 |
|
86 |
86 |
$40.49 |
| 85018 |
|
864 |
848 |
$31.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,593 |
3,521 |
$7.44 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,344 |
1,035 |
$3.88 |
| 90686 |
|
1,594 |
1,580 |
$2.74 |
| 90734 |
|
153 |
151 |
$0.51 |
| 90710 |
|
148 |
147 |
$0.27 |
| 90696 |
|
138 |
133 |
$0.25 |
| 90716 |
|
348 |
347 |
$0.22 |
| 90674 |
|
13 |
13 |
$0.17 |
| 90715 |
|
68 |
67 |
$0.16 |
| 90651 |
|
28 |
28 |
$0.15 |
| 99462 |
|
64 |
28 |
$0.00 |
| 90656 |
|
130 |
130 |
$0.00 |
| 99460 |
|
68 |
53 |
$0.00 |
| 90680 |
|
17 |
17 |
$0.00 |
| 99383 |
|
29 |
28 |
$0.00 |
| 99381 |
|
14 |
13 |
$0.00 |
| 90685 |
|
344 |
337 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
52 |
47 |
$0.00 |
| 90473 |
|
39 |
38 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
28 |
$0.00 |
| 90461 |
|
112 |
112 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
431 |
390 |
$0.00 |
| 81002 |
|
12 |
12 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
16 |
16 |
$0.00 |