| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
19,590 |
16,589 |
$3.70M |
| 3077F |
|
167 |
167 |
$880.00 |
| 3079F |
|
190 |
184 |
$780.00 |
| 3078F |
|
164 |
157 |
$670.00 |
| 3075F |
|
127 |
124 |
$460.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,147 |
1,137 |
$380.13 |
| 3074F |
|
125 |
124 |
$380.00 |
| 3080F |
|
82 |
82 |
$360.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,874 |
2,711 |
$80.00 |
| 3044F |
|
13 |
13 |
$40.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
126 |
123 |
$0.00 |
| 90723 |
|
162 |
162 |
$0.00 |
| 90686 |
|
246 |
246 |
$0.00 |
| 92551 |
|
355 |
355 |
$0.00 |
| 85018 |
|
69 |
69 |
$0.00 |
| 90680 |
|
28 |
28 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
176 |
175 |
$0.00 |
| 90647 |
|
79 |
79 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
49 |
$0.00 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
30 |
30 |
$0.00 |
| 99383 |
|
14 |
14 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,005 |
1,838 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
41 |
$0.00 |
| 90461 |
|
605 |
605 |
$0.00 |
| 3725F |
|
42 |
42 |
$0.00 |
| 99173 |
|
370 |
355 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
97 |
97 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
147 |
144 |
$0.00 |
| 90670 |
|
275 |
275 |
$0.00 |
| 81025 |
|
65 |
61 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
76 |
76 |
$0.00 |
| 90710 |
|
15 |
15 |
$0.00 |
| 83655 |
|
56 |
56 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
41 |
41 |
$0.00 |
| 90633 |
|
65 |
65 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |