| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,279 |
2,112 |
$432K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
90 |
90 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
87 |
87 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
471 |
469 |
$8K |
| 99050 |
|
107 |
105 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
220 |
219 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
64 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
52 |
$797.76 |
| 90674 |
|
29 |
29 |
$695.63 |
| 92015 |
Determination of refractive state |
40 |
40 |
$515.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
123 |
114 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,336 |
1,248 |
$0.00 |