| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,600 |
19,819 |
$5.97M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,603 |
1,161 |
$214K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,161 |
856 |
$162K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
417 |
334 |
$54K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
495 |
331 |
$54K |
| 99381 |
|
282 |
207 |
$25K |
| 99383 |
|
165 |
109 |
$10K |
| 99382 |
|
160 |
107 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
35 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
552 |
426 |
$6K |
| 99384 |
|
45 |
35 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55 |
49 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
14 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
893 |
249 |
$2K |
| 90680 |
|
561 |
399 |
$1K |
| 90723 |
|
332 |
251 |
$1K |
| 90633 |
|
200 |
152 |
$556.82 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$510.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
66 |
43 |
$390.34 |
| 90677 |
|
213 |
145 |
$278.41 |
| 90698 |
|
82 |
57 |
$0.00 |
| 90619 |
|
24 |
14 |
$0.00 |
| 90474 |
|
41 |
28 |
$0.00 |
| 90696 |
|
19 |
16 |
$0.00 |
| 90651 |
|
18 |
16 |
$0.00 |
| 90670 |
|
575 |
430 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
691 |
330 |
$0.00 |
| 90461 |
|
260 |
150 |
$0.00 |
| 90710 |
|
187 |
146 |
$0.00 |
| 99173 |
|
119 |
101 |
$0.00 |
| 90648 |
|
491 |
359 |
$0.00 |
| 90715 |
|
18 |
14 |
$0.00 |
| 90734 |
|
49 |
38 |
$0.00 |