| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,302 |
10,330 |
$2.18M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,120 |
948 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
58 |
55 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
55 |
53 |
$9K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
382 |
207 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
151 |
139 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,027 |
494 |
$199.16 |
| 90686 |
|
52 |
51 |
$179.71 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
28 |
$0.00 |
| 90461 |
|
205 |
172 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |