| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,913 |
4,252 |
$689K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,239 |
2,049 |
$119K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,144 |
1,047 |
$38K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,303 |
1,229 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
80 |
$5K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
292 |
278 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
29 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
376 |
355 |
$2K |
| 87428 |
|
127 |
119 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
247 |
109 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 81025 |
|
195 |
185 |
$431.25 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$223.33 |
| 90461 |
|
41 |
35 |
$144.30 |
| CP002 |
|
16 |
12 |
$140.00 |
| 87807 |
|
12 |
12 |
$99.00 |
| 90686 |
|
30 |
28 |
$54.42 |
| 81003 |
|
25 |
25 |
$24.57 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
89 |
87 |
$13.10 |
| 3074F |
|
15 |
12 |
$0.00 |
| 99173 |
|
31 |
31 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |