| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00003 |
Internal/system code - not a standard HCPCS code |
6,139 |
4,515 |
$1.05M |
| T1015 |
Clinic visit/encounter, all-inclusive |
6,340 |
5,700 |
$880K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
108 |
108 |
$444.24 |
| 92551 |
|
105 |
105 |
$212.28 |
| 85018 |
|
234 |
233 |
$73.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
172 |
160 |
$0.00 |
| 90633 |
|
27 |
27 |
$0.00 |
| 90670 |
|
76 |
76 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
98 |
96 |
$0.00 |
| 99173 |
|
89 |
89 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
72 |
72 |
$0.00 |
| 90681 |
|
36 |
36 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$0.00 |
| 92015 |
Determination of refractive state |
14 |
14 |
$0.00 |
| 90723 |
|
63 |
63 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |
| 90647 |
|
52 |
52 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
310 |
296 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
208 |
207 |
$0.00 |
| 90686 |
|
160 |
160 |
$0.00 |