| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,770 |
3,894 |
$683K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
679 |
615 |
$53.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
566 |
533 |
$40.00 |
| 90686 |
|
257 |
245 |
$33.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
141 |
131 |
$20.00 |
| 90651 |
|
101 |
88 |
$10.40 |
| 90688 |
|
102 |
95 |
$10.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
162 |
156 |
$5.00 |
| 90734 |
|
48 |
47 |
$4.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
108 |
95 |
$1.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,514 |
1,332 |
$1.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
84 |
83 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
105 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$0.00 |
| 90658 |
|
15 |
14 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
38 |
$0.00 |
| 90670 |
|
16 |
16 |
$0.00 |
| 96127 |
|
26 |
14 |
$0.00 |
| 3008F |
|
180 |
161 |
$0.00 |
| 90656 |
|
19 |
19 |
$0.00 |
| 85018 |
|
16 |
16 |
$0.00 |