| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
866 |
679 |
$169K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,071 |
6,653 |
$133K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
460 |
445 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
518 |
497 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
853 |
819 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
343 |
329 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
78 |
70 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
60 |
$3K |
| 90686 |
|
516 |
489 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
58 |
57 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
116 |
114 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
38 |
$2K |
| 0011A |
|
44 |
44 |
$1K |
| 96127 |
|
813 |
729 |
$1K |
| 90651 |
|
12 |
12 |
$1K |
| 99385 |
|
12 |
12 |
$771.72 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$721.35 |
| 90658 |
|
37 |
37 |
$530.33 |
| 90656 |
|
67 |
66 |
$346.84 |
| 96160 |
|
126 |
117 |
$227.43 |
| 3008F |
|
13 |
13 |
$120.00 |
| 82962 |
|
193 |
168 |
$25.53 |
| 3074F |
|
142 |
127 |
$3.00 |
| 81002 |
|
12 |
12 |
$2.38 |
| 3078F |
|
191 |
182 |
$2.00 |
| 3079F |
|
69 |
60 |
$1.00 |
| 3077F |
|
198 |
180 |
$1.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
399 |
258 |
$0.00 |
| 3080F |
|
43 |
41 |
$0.00 |