| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,526 |
7,021 |
$697K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
584 |
541 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
545 |
472 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
143 |
121 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
17 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20 |
17 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
51 |
40 |
$303.25 |
| 90633 |
|
82 |
77 |
$90.23 |
| 90648 |
|
241 |
225 |
$90.23 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,660 |
749 |
$0.00 |
| 90681 |
|
45 |
40 |
$0.00 |
| 90670 |
|
505 |
465 |
$0.00 |
| 90710 |
|
61 |
57 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,023 |
952 |
$0.00 |
| 90698 |
|
14 |
13 |
$0.00 |
| 90723 |
|
96 |
89 |
$0.00 |
| 90686 |
|
39 |
39 |
$0.00 |
| 96127 |
|
14 |
14 |
$0.00 |
| 90474 |
|
20 |
15 |
$0.00 |