| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,898 |
1,737 |
$382K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
91 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
51 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
17 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
516 |
496 |
$905.15 |
| 90651 |
|
38 |
38 |
$387.72 |
| 96160 |
|
244 |
238 |
$218.02 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
308 |
178 |
$51.90 |
| 99173 |
|
39 |
39 |
$0.00 |
| 90649 |
|
15 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| 90686 |
|
28 |
27 |
$0.00 |
| 86580 |
|
15 |
15 |
$0.00 |