| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,922 |
6,559 |
$1.04M |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
771 |
591 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,814 |
1,399 |
$9K |
| S5190 |
Wellness assessment, performed by non-physician |
270 |
194 |
$7K |
| 90648 |
|
234 |
139 |
$1K |
| 90723 |
|
122 |
57 |
$774.89 |
| 90686 |
|
905 |
696 |
$740.33 |
| 90670 |
|
199 |
104 |
$504.76 |
| 90734 |
|
12 |
12 |
$392.25 |
| 90620 |
|
12 |
12 |
$308.32 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
503 |
330 |
$268.35 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,683 |
1,957 |
$111.60 |
| 90474 |
|
16 |
12 |
$99.90 |
| 81025 |
|
780 |
577 |
$33.31 |
| 85018 |
|
55 |
40 |
$14.34 |
| 82962 |
|
291 |
170 |
$14.16 |
| 36415 |
Collection of venous blood by venipuncture |
455 |
391 |
$8.20 |
| 99173 |
|
364 |
269 |
$6.94 |
| 0502F |
|
1,027 |
592 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
337 |
227 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,066 |
789 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
239 |
181 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
342 |
200 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
94 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
28 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
975 |
548 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
79 |
$0.00 |