| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,665 |
5,448 |
$1.19M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
418 |
413 |
$66K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
326 |
313 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
304 |
285 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
169 |
157 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
904 |
857 |
$935.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
389 |
285 |
$287.36 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
202 |
186 |
$14.43 |
| 96161 |
|
380 |
345 |
$4.50 |
| 90461 |
|
1,355 |
583 |
$0.00 |
| 99051 |
|
186 |
164 |
$0.00 |
| 90633 |
|
120 |
119 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90734 |
|
41 |
40 |
$0.00 |
| 90710 |
|
98 |
98 |
$0.00 |
| 90649 |
|
51 |
46 |
$0.00 |
| 90670 |
|
355 |
336 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 96160 |
|
12 |
12 |
$0.00 |
| 90680 |
|
187 |
172 |
$0.00 |
| 92558 |
|
174 |
165 |
$0.00 |
| 90744 |
|
132 |
125 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
73 |
70 |
$0.00 |
| 90698 |
|
244 |
229 |
$0.00 |
| 90686 |
|
124 |
123 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
26 |
25 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
15 |
$0.00 |
| 90696 |
|
27 |
27 |
$0.00 |