| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,245 |
3,455 |
$538K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,064 |
3,287 |
$35K |
| 36415 |
Collection of venous blood by venipuncture |
197 |
169 |
$32.48 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
53 |
$1.42 |
| 87400 |
|
61 |
56 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
38 |
$0.00 |
| 81003 |
|
20 |
16 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
154 |
137 |
$0.00 |
| 85018 |
|
23 |
20 |
$0.00 |
| 90686 |
|
42 |
42 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
108 |
102 |
$0.00 |
| 81001 |
|
89 |
82 |
$0.00 |