| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,236 |
3,414 |
$695K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,102 |
1,792 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
27 |
$275.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
160 |
144 |
$227.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
27 |
$180.14 |
| 90686 |
|
95 |
90 |
$67.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
26 |
$10.18 |
| 90656 |
|
13 |
13 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |