| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,977 |
3,393 |
$422K |
| 99199 |
Unlisted special service, procedure or report |
25,937 |
11,070 |
$142K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,673 |
1,197 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
375 |
276 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
270 |
213 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
259 |
202 |
$686.80 |
| 92552 |
|
38 |
38 |
$643.49 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
32 |
$425.01 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
12 |
$191.94 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
14 |
$122.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
45 |
27 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
61 |
35 |
$0.00 |