| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,928 |
1,781 |
$306K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
350 |
322 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
114 |
114 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
119 |
119 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
51 |
49 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$550.97 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16 |
16 |
$416.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
16 |
$393.01 |
| 92551 |
|
130 |
130 |
$304.02 |
| 99173 |
|
118 |
118 |
$157.00 |
| 96127 |
|
30 |
30 |
$22.00 |
| 96160 |
|
60 |
60 |
$20.11 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |