| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,477 |
7,450 |
$833K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
852 |
803 |
$29K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
197 |
195 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
491 |
476 |
$9K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
29 |
28 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
26 |
$528.00 |
| 90688 |
|
18 |
18 |
$321.24 |
| 90686 |
|
13 |
12 |
$287.04 |
| G0008 |
Administration of influenza virus vaccine |
28 |
28 |
$286.00 |
| 99173 |
|
82 |
80 |
$225.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
36 |
$220.00 |
| 92551 |
|
28 |
27 |
$114.40 |
| 92552 |
|
25 |
25 |
$26.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
17 |
$22.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
16 |
$15.38 |
| 94760 |
|
28 |
28 |
$5.20 |
| 1090F |
|
181 |
172 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| 1159F |
|
262 |
252 |
$0.00 |
| 3078F |
|
83 |
80 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
22 |
22 |
$0.00 |
| 1126F |
|
78 |
75 |
$0.00 |
| 3074F |
|
193 |
188 |
$0.00 |
| 1101F |
|
158 |
150 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$0.00 |
| 3008F |
|
224 |
217 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
100 |
97 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |
| 1036F |
|
72 |
68 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 3079F |
|
29 |
28 |
$0.00 |
| 1125F |
|
26 |
25 |
$0.00 |
| 1034F |
|
44 |
41 |
$0.00 |