| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
29,845 |
16,355 |
$2.06M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,134 |
2,177 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23,100 |
12,646 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,894 |
887 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
139 |
128 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,957 |
2,004 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,295 |
1,541 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
176 |
141 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,050 |
2,762 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,540 |
1,045 |
$3K |
| 99215 |
Prolong outpt/office vis |
31 |
29 |
$3K |
| 83655 |
|
905 |
516 |
$498.07 |
| 85018 |
|
3,291 |
2,186 |
$269.44 |
| 92551 |
|
1,261 |
829 |
$256.37 |
| 81002 |
|
3,032 |
1,895 |
$234.82 |
| 90474 |
|
1,123 |
729 |
$191.73 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
367 |
221 |
$141.76 |
| 80305 |
|
495 |
294 |
$116.74 |
| 81025 |
|
462 |
273 |
$82.68 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,125 |
1,386 |
$60.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
392 |
233 |
$46.19 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
103 |
43 |
$37.18 |
| 99173 |
|
1,682 |
1,075 |
$26.09 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,107 |
821 |
$10.50 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,307 |
941 |
$0.84 |
| 90633 |
|
717 |
444 |
$0.05 |
| 90647 |
|
466 |
202 |
$0.02 |
| 90681 |
|
616 |
283 |
$0.00 |
| 90670 |
|
1,424 |
858 |
$0.00 |
| 90707 |
|
358 |
244 |
$0.00 |
| 90648 |
|
15 |
13 |
$0.00 |
| 90734 |
|
67 |
59 |
$0.00 |
| H2020 |
Therapeutic behavioral services, per diem |
45 |
44 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
513 |
390 |
$0.00 |
| 90671 |
|
211 |
174 |
$0.00 |
| 90700 |
|
97 |
65 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
40 |
$0.00 |
| 90715 |
|
17 |
16 |
$0.00 |
| 87807 |
|
110 |
86 |
$0.00 |
| 90698 |
|
691 |
484 |
$0.00 |
| 90680 |
|
524 |
439 |
$0.00 |
| 90716 |
|
370 |
260 |
$0.00 |
| 90677 |
|
192 |
173 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
496 |
404 |
$0.00 |
| 90697 |
|
234 |
187 |
$0.00 |
| 90723 |
|
222 |
83 |
$0.00 |
| 90744 |
|
235 |
179 |
$0.00 |
| 99381 |
|
98 |
67 |
$0.00 |
| 90686 |
|
41 |
37 |
$0.00 |
| 90651 |
|
44 |
28 |
$0.00 |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
22 |
13 |
$0.00 |