| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,991 |
10,523 |
$1.55M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
266 |
253 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
204 |
201 |
$33K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
192 |
192 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
76 |
75 |
$11K |
| CP005 |
|
428 |
337 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
540 |
457 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,233 |
696 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
128 |
125 |
$3K |
| CP006 |
|
119 |
97 |
$2K |
| 90656 |
|
29 |
28 |
$233.26 |
| 90681 |
|
27 |
27 |
$127.67 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
209 |
200 |
$127.67 |
| 90715 |
|
28 |
26 |
$120.47 |
| 90461 |
|
1,142 |
420 |
$1.20 |
| 3078F |
|
218 |
218 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
84 |
80 |
$0.00 |
| 90670 |
|
48 |
45 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 3074F |
|
239 |
239 |
$0.00 |
| 90677 |
|
128 |
128 |
$0.00 |
| 3008F |
|
711 |
677 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 90686 |
|
45 |
45 |
$0.00 |