| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,793 |
7,393 |
$905K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
208 |
205 |
$885.60 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
90 |
$630.56 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,211 |
4,531 |
$573.32 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
147 |
143 |
$535.08 |
| 90651 |
|
13 |
13 |
$147.84 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
13 |
$93.88 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,212 |
1,133 |
$70.31 |
| 90686 |
|
205 |
202 |
$51.15 |
| 36415 |
Collection of venous blood by venipuncture |
667 |
635 |
$50.51 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
157 |
$31.58 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$16.05 |
| 3008F |
|
114 |
111 |
$0.00 |
| 90656 |
|
38 |
38 |
$0.00 |
| 99177 |
|
53 |
53 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |