| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,280 |
1,575 |
$596K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,068 |
666 |
$656.07 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
775 |
505 |
$591.30 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
115 |
67 |
$86.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
157 |
116 |
$73.64 |
| 96150 |
|
204 |
142 |
$56.91 |
| 90688 |
|
62 |
39 |
$33.90 |
| 1159F |
|
44 |
42 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
119 |
107 |
$0.00 |
| 99173 |
|
87 |
76 |
$0.00 |
| 3078F |
|
22 |
22 |
$0.00 |
| 90715 |
|
22 |
18 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
21 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
18 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 1036F |
|
40 |
38 |
$0.00 |
| 96151 |
|
256 |
163 |
$0.00 |
| 1126F |
|
17 |
17 |
$0.00 |
| 90686 |
|
95 |
60 |
$0.00 |
| 99000 |
|
169 |
104 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
35 |
32 |
$0.00 |
| 3008F |
|
23 |
23 |
$0.00 |
| 92551 |
|
92 |
81 |
$0.00 |
| 3074F |
|
22 |
22 |
$0.00 |
| 2001F |
|
23 |
23 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |