| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,220 |
10,073 |
$656K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,649 |
5,212 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,249 |
3,079 |
$12K |
| 90686 |
|
769 |
768 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,260 |
1,251 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
64 |
64 |
$801.20 |
| 90671 |
|
13 |
13 |
$738.60 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
40 |
40 |
$459.67 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
121 |
121 |
$319.57 |
| 96127 |
|
792 |
622 |
$315.78 |
| 90656 |
|
53 |
53 |
$280.50 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
284 |
282 |
$246.77 |
| 90480 |
|
12 |
12 |
$210.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
25 |
25 |
$184.84 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
81 |
81 |
$152.91 |
| 0124A |
|
26 |
26 |
$151.21 |
| 91300 |
|
15 |
14 |
$0.00 |
| 90750 |
|
14 |
13 |
$0.00 |
| 36416 |
|
444 |
428 |
$0.00 |