| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
7,354 |
5,797 |
$849K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,181 |
2,234 |
$176K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
584 |
572 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
366 |
345 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
310 |
308 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 99385 |
|
12 |
12 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,861 |
1,550 |
$610.68 |
| 90461 |
|
928 |
775 |
$67.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,226 |
1,052 |
$57.82 |
| 81003 |
|
157 |
130 |
$9.45 |
| 81025 |
|
20 |
19 |
$7.23 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
95 |
87 |
$0.00 |
| 99173 |
|
343 |
341 |
$0.00 |
| 90648 |
|
54 |
51 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
74 |
71 |
$0.00 |
| 90670 |
|
183 |
181 |
$0.00 |
| 90681 |
|
26 |
26 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 92551 |
|
531 |
529 |
$0.00 |
| 90677 |
|
238 |
237 |
$0.00 |
| 90686 |
|
365 |
364 |
$0.00 |
| 90698 |
|
209 |
208 |
$0.00 |
| 90656 |
|
104 |
104 |
$0.00 |
| 96127 |
|
76 |
68 |
$0.00 |
| 90680 |
|
77 |
76 |
$0.00 |
| 90744 |
|
43 |
43 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |