| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,458 |
2,496 |
$243K |
| 81002 |
|
127 |
120 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
468 |
267 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
188 |
109 |
$0.00 |
| 90670 |
|
162 |
99 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
65 |
$0.00 |
| 90633 |
|
138 |
92 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
20 |
$0.00 |
| 99173 |
|
223 |
160 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
78 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
139 |
59 |
$0.00 |
| 90710 |
|
33 |
14 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
52 |
29 |
$0.00 |
| 92551 |
|
203 |
144 |
$0.00 |
| 90698 |
|
36 |
27 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
480 |
312 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
674 |
383 |
$0.00 |
| 36416 |
|
169 |
140 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
510 |
395 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,757 |
1,477 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
345 |
183 |
$0.00 |
| 85018 |
|
169 |
138 |
$0.00 |
| 90651 |
|
63 |
27 |
$0.00 |
| 90744 |
|
31 |
12 |
$0.00 |
| 99383 |
|
23 |
13 |
$0.00 |
| 90686 |
|
22 |
14 |
$0.00 |