| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,487 |
2,130 |
$457K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
498 |
484 |
$9K |
| 99382 |
|
14 |
14 |
$3K |
| 99383 |
|
12 |
12 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
138 |
134 |
$2K |
| 0001A |
|
25 |
25 |
$1K |
| 99173 |
|
33 |
33 |
$764.61 |
| 90686 |
|
24 |
24 |
$340.00 |
| 92015 |
Determination of refractive state |
12 |
12 |
$154.56 |
| 92551 |
|
15 |
15 |
$143.55 |
| 90715 |
|
14 |
14 |
$105.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
81 |
76 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
45 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
978 |
878 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
112 |
$0.00 |