| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,918 |
1,622 |
$514K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$26.00 |
| 92551 |
|
59 |
54 |
$7.20 |
| 99173 |
|
60 |
55 |
$5.40 |
| 3074F |
|
202 |
188 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
464 |
387 |
$0.00 |
| 3079F |
|
39 |
39 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
38 |
33 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
93 |
79 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
17 |
15 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
39 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$0.00 |
| 92015 |
Determination of refractive state |
14 |
13 |
$0.00 |
| 3078F |
|
141 |
127 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
44 |
43 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
58 |
54 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 97803 |
|
84 |
71 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 3077F |
|
27 |
24 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
28 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |