| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,001 |
4,350 |
$300K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,811 |
2,542 |
$141K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
802 |
726 |
$54K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 90674 |
|
163 |
163 |
$2K |
| 90688 |
|
184 |
179 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
117 |
58 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$983.28 |
| 90686 |
|
32 |
32 |
$308.61 |
| 36415 |
Collection of venous blood by venipuncture |
137 |
126 |
$260.42 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
30 |
$200.40 |
| 81002 |
|
14 |
13 |
$37.44 |
| 94760 |
|
44 |
42 |
$0.00 |
| 99000 |
|
15 |
14 |
$0.00 |
| 90461 |
|
37 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
150 |
57 |
$0.00 |