| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,386 |
6,507 |
$800K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
158 |
151 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
91 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
33 |
31 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
649 |
509 |
$2K |
| 99381 |
|
111 |
97 |
$442.89 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
259 |
247 |
$42.63 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
163 |
112 |
$22.84 |
| S8301 |
Infection control supplies, not otherwise specified |
1,844 |
1,467 |
$9.50 |
| 96160 |
|
321 |
293 |
$2.48 |
| 92551 |
|
688 |
671 |
$0.00 |
| 87428 |
|
195 |
181 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
676 |
665 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
199 |
199 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
207 |
193 |
$0.00 |
| 99050 |
|
20 |
17 |
$0.00 |
| 96161 |
|
219 |
197 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
28 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
208 |
208 |
$0.00 |
| 90686 |
|
51 |
51 |
$0.00 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
59 |
59 |
$0.00 |
| 96127 |
|
106 |
103 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
75 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| 90688 |
|
37 |
37 |
$0.00 |
| 92552 |
|
33 |
32 |
$0.00 |
| 99173 |
|
710 |
692 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
36 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
239 |
239 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
64 |
59 |
$0.00 |