| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,163 |
6,699 |
$777K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
202 |
181 |
$19K |
| 90688 |
|
762 |
755 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
294 |
280 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
748 |
728 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
686 |
675 |
$2K |
| 90656 |
|
219 |
215 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
67 |
$952.00 |
| 90686 |
|
107 |
103 |
$800.00 |
| 90670 |
|
91 |
91 |
$728.00 |
| 90633 |
|
67 |
62 |
$488.00 |
| 90655 |
|
60 |
60 |
$456.00 |
| 90685 |
|
44 |
44 |
$344.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$264.00 |
| 90677 |
|
30 |
29 |
$232.00 |
| 90648 |
|
28 |
28 |
$224.00 |
| 90680 |
|
24 |
24 |
$192.00 |
| 90698 |
|
24 |
24 |
$192.00 |
| 90710 |
|
15 |
15 |
$120.00 |
| 90723 |
|
13 |
13 |
$104.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,891 |
3,274 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
270 |
262 |
$0.00 |
| 99348 |
|
233 |
184 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
15 |
12 |
$0.00 |