| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,644 |
12,300 |
$1.08M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
883 |
835 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
627 |
600 |
$47K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
669 |
596 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
416 |
394 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
190 |
163 |
$2K |
| 90651 |
|
62 |
58 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,006 |
1,537 |
$568.65 |
| 90686 |
|
28 |
28 |
$178.72 |
| 90677 |
|
19 |
18 |
$97.03 |
| 90734 |
|
140 |
138 |
$89.36 |
| 90715 |
|
72 |
72 |
$87.52 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
15 |
$34.00 |
| 90461 |
|
765 |
706 |
$23.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
34 |
34 |
$15.72 |
| 90656 |
|
45 |
44 |
$0.00 |
| 90698 |
|
62 |
62 |
$0.00 |
| 90680 |
|
32 |
32 |
$0.00 |
| 90696 |
|
18 |
18 |
$0.00 |
| 90688 |
|
29 |
29 |
$0.00 |
| 90744 |
|
26 |
26 |
$0.00 |
| 90633 |
|
88 |
88 |
$0.00 |
| 90473 |
|
93 |
90 |
$0.00 |
| 90670 |
|
131 |
131 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90710 |
|
41 |
41 |
$0.00 |
| 90700 |
|
26 |
26 |
$0.00 |