| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
175 |
174 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,248 |
1,056 |
$24K |
| 90651 |
|
113 |
107 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
909 |
827 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
449 |
377 |
$14K |
| 90734 |
|
100 |
94 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
151 |
148 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
514 |
486 |
$12K |
| 90686 |
|
454 |
416 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
328 |
295 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
343 |
326 |
$7K |
| 90461 |
|
175 |
167 |
$5K |
| 92551 |
|
1,098 |
1,040 |
$2K |
| 90633 |
|
53 |
48 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
44 |
$941.43 |
| 99460 |
|
12 |
12 |
$912.52 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
44 |
44 |
$857.18 |
| G0008 |
Administration of influenza virus vaccine |
197 |
182 |
$712.70 |
| WA061 |
|
26 |
26 |
$511.42 |
| 90715 |
|
15 |
14 |
$458.98 |
| 99188 |
|
26 |
25 |
$456.12 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
95 |
71 |
$449.71 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
45 |
36 |
$305.08 |
| 90670 |
|
13 |
13 |
$179.50 |
| 90698 |
|
13 |
13 |
$175.00 |
| 99051 |
|
79 |
68 |
$98.62 |
| 85018 |
|
14 |
14 |
$59.39 |
| 99173 |
|
984 |
946 |
$14.94 |
| 83655 |
|
13 |
13 |
$0.00 |
| 96161 |
|
13 |
13 |
$0.00 |