| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,993 |
1,908 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,601 |
1,569 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,034 |
1,993 |
$75K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
600 |
600 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
446 |
444 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
261 |
261 |
$17K |
| 99215 |
Prolong outpt/office vis |
138 |
134 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
174 |
173 |
$9K |
| 99051 |
|
256 |
254 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
121 |
118 |
$1K |
| 90686 |
|
179 |
175 |
$905.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
29 |
$361.70 |
| 99188 |
|
26 |
26 |
$277.20 |
| 92551 |
|
817 |
817 |
$216.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
234 |
232 |
$161.68 |
| 90734 |
|
13 |
13 |
$156.00 |
| 99177 |
|
127 |
127 |
$79.29 |
| 96160 |
|
221 |
221 |
$57.43 |
| 96127 |
|
209 |
209 |
$49.28 |
| 81002 |
|
12 |
12 |
$25.77 |
| 99173 |
|
178 |
178 |
$0.00 |
| G9920 |
Screening performed and negative |
239 |
239 |
$0.00 |
| 90648 |
|
15 |
15 |
$0.00 |
| 90661 |
|
12 |
12 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
85 |
85 |
$0.00 |
| 3008F |
|
619 |
608 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| 96161 |
|
27 |
27 |
$0.00 |