| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,250 |
1,199 |
$151K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
30 |
$390.59 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
130 |
130 |
$308.00 |
| 96127 |
|
201 |
196 |
$0.00 |
| 3008F |
|
515 |
505 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
152 |
152 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
152 |
152 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| 1160F |
|
412 |
404 |
$0.00 |
| 1032F |
|
47 |
46 |
$0.00 |
| 1159F |
|
65 |
63 |
$0.00 |
| 99173 |
|
60 |
60 |
$0.00 |
| 92552 |
|
32 |
32 |
$0.00 |
| 99442 |
|
32 |
31 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$0.00 |