| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,514 |
6,908 |
$294K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,023 |
1,927 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,183 |
2,007 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
622 |
622 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
544 |
539 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
342 |
342 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
861 |
853 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
499 |
495 |
$2K |
| 99215 |
Prolong outpt/office vis |
90 |
89 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
38 |
38 |
$672.39 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
57 |
57 |
$567.77 |
| 99205 |
Prolong outpt/office vis |
16 |
16 |
$497.27 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
79 |
79 |
$390.27 |
| 90677 |
|
25 |
25 |
$328.36 |
| 90686 |
|
150 |
150 |
$123.18 |
| 90670 |
|
167 |
167 |
$0.00 |
| 90461 |
|
32 |
32 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90723 |
|
75 |
75 |
$0.00 |
| 90647 |
|
136 |
136 |
$0.00 |