| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
25,240 |
21,108 |
$2.67M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,122 |
15,932 |
$154K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
757 |
756 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,763 |
4,412 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,194 |
1,138 |
$10K |
| 90686 |
|
1,038 |
1,028 |
$9K |
| 99173 |
|
892 |
890 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
467 |
455 |
$4K |
| 92551 |
|
926 |
926 |
$3K |
| 99205 |
Prolong outpt/office vis |
120 |
119 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
157 |
156 |
$2K |
| 99188 |
|
95 |
95 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
456 |
453 |
$2K |
| 90715 |
|
80 |
80 |
$2K |
| G9920 |
Screening performed and negative |
46 |
46 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
62 |
61 |
$1K |
| 99215 |
Prolong outpt/office vis |
404 |
392 |
$1K |
| 81002 |
|
267 |
240 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
100 |
100 |
$836.92 |
| 90723 |
|
70 |
69 |
$820.02 |
| 90670 |
|
190 |
188 |
$802.90 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
38 |
36 |
$787.50 |
| 92081 |
|
18 |
18 |
$747.36 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
67 |
66 |
$513.36 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
80 |
80 |
$296.04 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$288.00 |
| 99383 |
|
51 |
51 |
$207.27 |
| 85018 |
|
83 |
83 |
$198.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$178.75 |
| 90651 |
|
139 |
139 |
$90.68 |
| 90648 |
|
110 |
106 |
$82.11 |
| 90633 |
|
111 |
111 |
$49.44 |
| 90620 |
|
12 |
12 |
$38.88 |
| 1159F |
|
273 |
248 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 81025 |
|
38 |
36 |
$0.00 |
| 1160F |
|
92 |
89 |
$0.00 |
| 90734 |
|
28 |
28 |
$0.00 |
| 3078F |
|
93 |
89 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |
| 3008F |
|
374 |
357 |
$0.00 |
| 1126F |
|
31 |
29 |
$0.00 |
| 1036F |
|
221 |
212 |
$0.00 |
| 3074F |
|
142 |
138 |
$0.00 |
| 99385 |
|
13 |
13 |
$0.00 |
| 99384 |
|
26 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
15 |
$0.00 |
| 3079F |
|
14 |
13 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |