| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
28,405 |
20,788 |
$2.35M |
| 99199 |
Unlisted special service, procedure or report |
126,390 |
55,408 |
$574K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,747 |
4,348 |
$356K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,997 |
3,958 |
$315K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,942 |
1,527 |
$120K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
11,768 |
9,204 |
$113K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
7,931 |
6,043 |
$112K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,098 |
1,762 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
462 |
353 |
$33K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,140 |
3,350 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,731 |
2,279 |
$26K |
| 90474 |
|
1,766 |
1,410 |
$18K |
| D0145 |
Oral evaluation for a patient under three years of age |
677 |
545 |
$18K |
| D1206 |
Topical application of fluoride varnish |
731 |
583 |
$9K |
| 83655 |
|
820 |
672 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
330 |
216 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
152 |
119 |
$7K |
| 96161 |
|
2,086 |
1,459 |
$7K |
| 87807 |
|
369 |
288 |
$5K |
| 99173 |
|
4,033 |
3,058 |
$4K |
| 92551 |
|
1,914 |
1,431 |
$3K |
| 85018 |
|
912 |
716 |
$3K |
| 90677 |
|
448 |
386 |
$2K |
| 99460 |
|
31 |
26 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
44 |
31 |
$1K |
| 87428 |
|
25 |
25 |
$1K |
| 90697 |
|
621 |
445 |
$1K |
| 99381 |
|
14 |
12 |
$975.36 |
| 90834 |
Psychotherapy, 45 minutes with patient |
16 |
13 |
$850.82 |
| 90670 |
|
3,776 |
2,912 |
$563.51 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$214.70 |
| 90686 |
|
2,905 |
2,282 |
$148.47 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16 |
15 |
$147.15 |
| 82247 |
|
43 |
29 |
$145.09 |
| 81003 |
|
17 |
12 |
$75.84 |
| 90633 |
|
1,158 |
901 |
$71.39 |
| 90661 |
|
12 |
12 |
$67.26 |
| 96127 |
|
49 |
44 |
$27.47 |
| 90710 |
|
972 |
731 |
$24.64 |
| 90734 |
|
245 |
169 |
$0.02 |
| 90715 |
|
75 |
52 |
$0.02 |
| 90698 |
|
583 |
454 |
$0.01 |
| 90680 |
|
1,101 |
893 |
$0.00 |
| 90723 |
|
962 |
763 |
$0.00 |
| 90647 |
|
395 |
305 |
$0.00 |
| 90688 |
|
71 |
64 |
$0.00 |
| 90651 |
|
141 |
120 |
$0.00 |
| 90696 |
|
58 |
28 |
$0.00 |
| 90744 |
|
15 |
13 |
$0.00 |
| 90681 |
|
600 |
441 |
$0.00 |
| 90648 |
|
74 |
74 |
$0.00 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
12 |
12 |
$0.00 |