| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,913 |
5,446 |
$733K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
327 |
323 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
283 |
282 |
$45K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
50 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$4K |
| 99381 |
|
30 |
30 |
$4K |
| 99382 |
|
14 |
14 |
$2K |
| 90633 |
|
69 |
69 |
$0.00 |
| 90461 |
|
603 |
529 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,286 |
939 |
$0.00 |
| 90681 |
|
74 |
74 |
$0.00 |
| 90648 |
|
80 |
79 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90670 |
|
100 |
99 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90686 |
|
144 |
140 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90677 |
|
205 |
205 |
$0.00 |
| 90656 |
|
48 |
48 |
$0.00 |
| 90698 |
|
41 |
41 |
$0.00 |
| 90723 |
|
26 |
26 |
$0.00 |