| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,770 |
2,863 |
$866K |
| 99199 |
Unlisted special service, procedure or report |
15,056 |
9,502 |
$89K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
187 |
170 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
234 |
208 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
27 |
$1K |
| 90656 |
|
140 |
132 |
$630.06 |
| 90686 |
|
13 |
12 |
$234.93 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
29 |
28 |
$170.16 |
| 91322 |
|
14 |
13 |
$146.05 |
| 90480 |
|
14 |
13 |
$28.39 |
| 1160F |
|
2,011 |
1,717 |
$0.00 |
| 3078F |
|
1,444 |
1,233 |
$0.00 |
| 1159F |
|
2,010 |
1,717 |
$0.00 |
| 4274F |
|
627 |
509 |
$0.00 |
| 3077F |
|
91 |
85 |
$0.00 |
| 3074F |
|
1,552 |
1,337 |
$0.00 |
| 2010F |
|
2,389 |
2,046 |
$0.00 |
| 3079F |
|
241 |
228 |
$0.00 |
| 2001F |
|
2,276 |
1,966 |
$0.00 |
| 3008F |
|
2,227 |
1,924 |
$0.00 |
| 2000F |
|
2,296 |
1,979 |
$0.00 |
| 1036F |
|
2,039 |
1,760 |
$0.00 |
| 90620 |
|
15 |
14 |
$0.00 |
| 3075F |
|
117 |
112 |
$0.00 |
| 3351F |
|
321 |
281 |
$0.00 |
| 1034F |
|
52 |
42 |
$0.00 |
| 4037F |
|
125 |
117 |
$0.00 |
| 3080F |
|
14 |
13 |
$0.00 |