| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,604 |
4,055 |
$445K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
708 |
693 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
126 |
126 |
$395.70 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
107 |
107 |
$394.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,117 |
1,041 |
$390.09 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,785 |
1,599 |
$369.20 |
| 90461 |
|
115 |
113 |
$273.26 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
181 |
180 |
$178.36 |
| 90686 |
|
335 |
332 |
$67.30 |
| 36415 |
Collection of venous blood by venipuncture |
639 |
611 |
$29.17 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
71 |
68 |
$12.01 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
85 |
$10.18 |
| 85018 |
|
48 |
45 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$0.00 |
| 83655 |
|
13 |
13 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
101 |
97 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 90670 |
|
39 |
36 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$0.00 |
| 80061 |
Lipid panel |
25 |
25 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 81003 |
|
15 |
14 |
$0.00 |