| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,554 |
1,425 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
178 |
166 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
152 |
143 |
$7K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
69 |
67 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
33 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
118 |
105 |
$1K |
| 90686 |
|
14 |
14 |
$215.40 |
| 90633 |
|
14 |
14 |
$183.96 |
| 90647 |
|
12 |
12 |
$182.25 |
| 90696 |
|
13 |
13 |
$170.82 |
| 90710 |
|
13 |
13 |
$170.82 |
| 90670 |
|
13 |
13 |
$170.82 |
| 90734 |
|
12 |
12 |
$157.68 |