| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,862 |
9,455 |
$1.62M |
| 90734 |
|
186 |
152 |
$767.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,983 |
4,131 |
$273.15 |
| 90686 |
|
434 |
329 |
$254.30 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
409 |
369 |
$145.94 |
| 90715 |
|
115 |
95 |
$96.15 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
272 |
230 |
$84.62 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
861 |
784 |
$69.52 |
| 3078F |
|
1,095 |
960 |
$17.00 |
| 3074F |
|
1,160 |
1,014 |
$17.00 |
| 90744 |
|
217 |
181 |
$12.80 |
| 90461 |
|
1,031 |
998 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,741 |
1,678 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,004 |
852 |
$0.00 |
| 90670 |
|
924 |
800 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,119 |
875 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
622 |
524 |
$0.00 |
| 90633 |
|
455 |
393 |
$0.00 |
| 99173 |
|
320 |
267 |
$0.00 |
| 90707 |
|
313 |
264 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
130 |
93 |
$0.00 |
| 90700 |
|
38 |
26 |
$0.00 |
| 90681 |
|
42 |
42 |
$0.00 |
| 90648 |
|
37 |
25 |
$0.00 |
| 90696 |
|
62 |
55 |
$0.00 |
| 90680 |
|
149 |
133 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,252 |
1,782 |
$0.00 |
| 90697 |
|
214 |
213 |
$0.00 |
| 90651 |
|
406 |
353 |
$0.00 |
| 90698 |
|
642 |
555 |
$0.00 |
| 90688 |
|
17 |
17 |
$0.00 |
| 90677 |
|
139 |
136 |
$0.00 |
| 90716 |
|
355 |
301 |
$0.00 |
| 99381 |
|
14 |
14 |
$0.00 |
| 90619 |
|
57 |
57 |
$0.00 |
| 3044F |
|
14 |
12 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |