| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,584 |
10,990 |
$2.24M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,808 |
1,807 |
$312K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,315 |
1,315 |
$227K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
891 |
890 |
$147K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,701 |
3,687 |
$68K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,212 |
5,174 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
300 |
276 |
$50K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,622 |
1,581 |
$24K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
56 |
56 |
$9K |
| 99050 |
|
108 |
108 |
$6K |
| 87400 |
|
171 |
171 |
$2K |
| 86580 |
|
233 |
233 |
$1K |
| 85018 |
|
446 |
444 |
$1K |
| 0124A |
|
17 |
17 |
$756.50 |
| 0111A |
|
16 |
16 |
$712.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
35 |
35 |
$638.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
31 |
$406.87 |
| 81002 |
|
99 |
97 |
$207.23 |
| 90686 |
|
770 |
770 |
$0.00 |
| 91311 |
|
16 |
16 |
$0.00 |
| 91312 |
|
17 |
17 |
$0.00 |