| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,162 |
7,625 |
$857K |
| 90670 |
|
354 |
352 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,082 |
948 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
70 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
471 |
451 |
$0.00 |
| 90648 |
|
473 |
455 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
153 |
147 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,078 |
1,043 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
66 |
66 |
$0.00 |
| 90633 |
|
78 |
77 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
28 |
27 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
101 |
93 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
16 |
$0.00 |
| 90686 |
|
290 |
269 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,802 |
4,175 |
$0.00 |
| 96127 |
|
1,182 |
1,130 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,511 |
1,466 |
$0.00 |
| 90723 |
|
319 |
312 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
316 |
301 |
$0.00 |
| 90680 |
|
189 |
186 |
$0.00 |
| 92551 |
|
819 |
782 |
$0.00 |
| 90677 |
|
121 |
119 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |