| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,807 |
2,154 |
$456K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,839 |
3,406 |
$55K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,365 |
2,079 |
$53K |
| 90651 |
|
511 |
418 |
$8K |
| 90686 |
|
863 |
788 |
$6K |
| 0012A |
|
101 |
101 |
$3K |
| 90715 |
|
481 |
410 |
$3K |
| 0011A |
|
115 |
113 |
$3K |
| 0064A |
|
87 |
65 |
$2K |
| 90746 |
|
52 |
38 |
$2K |
| 90734 |
|
342 |
252 |
$2K |
| 90707 |
|
56 |
39 |
$1K |
| 0071A |
|
35 |
30 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,104 |
907 |
$223.98 |
| 90619 |
|
54 |
48 |
$24.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,118 |
897 |
$2.39 |
| 91301 |
|
120 |
114 |
$0.00 |
| 2001F |
|
27 |
24 |
$0.00 |
| 91306 |
|
17 |
16 |
$0.00 |
| 3008F |
|
27 |
24 |
$0.00 |
| 90696 |
|
22 |
14 |
$0.00 |
| 3074F |
|
12 |
12 |
$0.00 |
| 91307 |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
12 |
$0.00 |
| 90633 |
|
135 |
100 |
$0.00 |
| 1159F |
|
28 |
25 |
$0.00 |
| 90710 |
|
70 |
60 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |