| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,908 |
1,604 |
$297K |
| 85018 |
|
151 |
70 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
111 |
73 |
$0.00 |
| 90686 |
|
234 |
165 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,335 |
753 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
32 |
15 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
185 |
108 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
26 |
$0.00 |
| 81000 |
|
51 |
27 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
197 |
128 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
119 |
70 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
37 |
$0.00 |
| 90461 |
|
86 |
39 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
13 |
$0.00 |