| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,831 |
2,258 |
$229K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
284 |
275 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
253 |
250 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
60 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
59 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,341 |
446 |
$54.88 |
| 90461 |
|
367 |
289 |
$7.84 |
| 90680 |
|
43 |
43 |
$0.00 |
| 90698 |
|
70 |
69 |
$0.00 |
| 90686 |
|
24 |
24 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90670 |
|
145 |
145 |
$0.00 |