| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,418 |
24,507 |
$4.01M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,450 |
1,338 |
$198K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,178 |
1,173 |
$169K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
874 |
871 |
$126K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
881 |
874 |
$125K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
761 |
739 |
$38K |
| 99307 |
|
746 |
727 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
332 |
323 |
$25K |
| 90686 |
|
666 |
658 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
94 |
82 |
$5K |
| 91307 |
|
94 |
92 |
$5K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
80 |
79 |
$4K |
| 90651 |
|
256 |
255 |
$3K |
| 0002A |
|
66 |
65 |
$2K |
| 0001A |
|
51 |
51 |
$2K |
| 90633 |
|
411 |
410 |
$850.65 |
| 90648 |
|
640 |
637 |
$424.34 |
| 90670 |
|
1,111 |
1,101 |
$285.52 |
| 90715 |
|
147 |
145 |
$285.52 |
| 90700 |
|
131 |
131 |
$283.55 |
| 90734 |
|
280 |
279 |
$281.58 |
| 91300 |
|
373 |
319 |
$281.58 |
| 0071A |
|
12 |
12 |
$196.34 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
13 |
12 |
$145.76 |
| 90680 |
|
335 |
330 |
$142.76 |
| 90696 |
|
132 |
132 |
$140.79 |
| 90461 |
|
1,879 |
1,614 |
$23.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,937 |
2,482 |
$15.68 |
| 90698 |
|
209 |
204 |
$0.00 |
| 92551 |
|
1,436 |
1,428 |
$0.00 |
| 90716 |
|
77 |
77 |
$0.00 |
| 90723 |
|
334 |
332 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
27 |
27 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
648 |
639 |
$0.00 |
| 90474 |
|
83 |
80 |
$0.00 |
| 90744 |
|
14 |
12 |
$0.00 |
| 90619 |
|
19 |
18 |
$0.00 |
| 99173 |
|
1,431 |
1,421 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
670 |
390 |
$0.00 |
| 90707 |
|
73 |
73 |
$0.00 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
12 |
$0.00 |
| 90710 |
|
135 |
135 |
$0.00 |
| 90672 |
|
23 |
23 |
$0.00 |