| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,703 |
5,761 |
$1.57M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
287 |
284 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
80 |
80 |
$624.26 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
59 |
$551.74 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$474.84 |
| 90461 |
|
18 |
18 |
$231.22 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,941 |
1,784 |
$66.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,916 |
2,595 |
$36.75 |
| 90686 |
|
172 |
170 |
$33.65 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
57 |
56 |
$5.09 |
| 36415 |
Collection of venous blood by venipuncture |
164 |
153 |
$3.17 |
| 3008F |
|
55 |
55 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
16 |
15 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
55 |
55 |
$0.00 |
| 99173 |
|
67 |
67 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |