| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
669 |
607 |
$120K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
239 |
223 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$271.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
163 |
159 |
$240.78 |
| 99173 |
|
154 |
154 |
$136.60 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$107.12 |
| 92551 |
|
148 |
148 |
$73.72 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
56 |
56 |
$47.55 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
113 |
113 |
$40.56 |
| 3008F |
|
526 |
503 |
$0.00 |