| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,281 |
10,521 |
$1.77M |
| 00003 |
Internal/system code - not a standard HCPCS code |
69 |
66 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,175 |
4,944 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,105 |
822 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,668 |
2,043 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,821 |
1,027 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
244 |
139 |
$2K |
| 99384 |
|
42 |
30 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
199 |
129 |
$1K |
| 90715 |
|
206 |
154 |
$853.13 |
| 90716 |
|
81 |
62 |
$522.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
111 |
93 |
$519.48 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
28 |
$502.95 |
| 90713 |
|
95 |
71 |
$450.00 |
| 90651 |
|
294 |
213 |
$378.00 |
| 99383 |
|
28 |
26 |
$274.15 |
| 90686 |
|
856 |
702 |
$259.64 |
| 90733 |
|
88 |
62 |
$132.38 |
| 90707 |
|
22 |
14 |
$108.00 |
| 90744 |
|
45 |
37 |
$90.00 |
| 90633 |
|
219 |
172 |
$63.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
97 |
59 |
$58.43 |
| 86580 |
|
14 |
12 |
$30.24 |
| 92551 |
|
144 |
144 |
$29.97 |
| 90672 |
|
98 |
81 |
$0.13 |
| 99000 |
|
303 |
291 |
$0.00 |
| 90656 |
|
78 |
55 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
287 |
286 |
$0.00 |
| 99173 |
|
133 |
133 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
26 |
$0.00 |
| 90734 |
|
19 |
14 |
$0.00 |
| 99442 |
|
107 |
76 |
$0.00 |