| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
24,769 |
20,941 |
$5.07M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,857 |
7,227 |
$1.43M |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
3,725 |
2,898 |
$735K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,006 |
3,863 |
$686K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,192 |
3,086 |
$545K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,114 |
2,834 |
$462K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,183 |
1,156 |
$216K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
537 |
526 |
$98K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
489 |
481 |
$86K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,033 |
3,666 |
$71K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,134 |
1,754 |
$71K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
502 |
414 |
$66K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
310 |
304 |
$53K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,097 |
1,055 |
$26K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,597 |
1,018 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,589 |
1,218 |
$14K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
596 |
585 |
$12K |
| 99381 |
|
52 |
50 |
$10K |
| 96127 |
|
94 |
90 |
$6K |
| 90473 |
|
340 |
334 |
$5K |
| 90461 |
|
2,502 |
2,313 |
$3K |
| 90670 |
|
1,990 |
1,931 |
$3K |
| 90686 |
|
459 |
453 |
$2K |
| 90633 |
|
929 |
910 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$2K |
| 90658 |
|
152 |
149 |
$1K |
| 90723 |
|
530 |
510 |
$971.06 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
56 |
54 |
$731.20 |
| 90651 |
|
130 |
128 |
$618.62 |
| 90677 |
|
561 |
555 |
$431.04 |
| 90657 |
|
18 |
18 |
$406.72 |
| 90700 |
|
99 |
97 |
$406.72 |
| 90715 |
|
80 |
78 |
$207.63 |
| 90698 |
|
245 |
237 |
$200.55 |
| 90734 |
|
126 |
123 |
$200.55 |
| 90662 |
|
172 |
144 |
$200.55 |
| 90648 |
|
914 |
880 |
$164.97 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
15 |
15 |
$63.68 |
| 90656 |
|
83 |
82 |
$0.03 |
| 90697 |
|
358 |
347 |
$0.00 |
| 90680 |
|
1,060 |
1,026 |
$0.00 |
| 90696 |
|
94 |
93 |
$0.00 |
| 90716 |
|
87 |
85 |
$0.00 |
| 90710 |
|
311 |
305 |
$0.00 |
| 90681 |
|
103 |
100 |
$0.00 |
| 90707 |
|
60 |
59 |
$0.00 |