| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
12,497 |
10,017 |
$3.82M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,683 |
2,349 |
$868.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
794 |
724 |
$149.58 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,583 |
2,428 |
$58.24 |
| 90686 |
|
582 |
491 |
$54.24 |
| 99173 |
|
1,185 |
1,108 |
$2.62 |
| 1159F |
|
885 |
829 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
379 |
357 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
882 |
812 |
$0.00 |
| 97803 |
|
230 |
218 |
$0.00 |
| 3078F |
|
683 |
658 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
783 |
708 |
$0.00 |
| D0190 |
|
310 |
288 |
$0.00 |
| D9996 |
|
427 |
382 |
$0.00 |
| 99177 |
|
49 |
49 |
$0.00 |
| 90670 |
|
147 |
145 |
$0.00 |
| 90671 |
|
86 |
85 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
39 |
38 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
23 |
22 |
$0.00 |
| 96167 |
|
48 |
41 |
$0.00 |
| 3074F |
|
688 |
663 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
622 |
566 |
$0.00 |
| D1330 |
|
456 |
402 |
$0.00 |
| 1126F |
|
730 |
697 |
$0.00 |
| 92551 |
|
1,314 |
1,233 |
$0.00 |
| 2001F |
|
949 |
897 |
$0.00 |
| 97802 |
|
405 |
396 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
418 |
376 |
$0.00 |
| 1036F |
|
397 |
375 |
$0.00 |
| 99000 |
|
195 |
191 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 90656 |
|
99 |
97 |
$0.00 |
| 3008F |
|
972 |
917 |
$0.00 |
| 90651 |
|
30 |
30 |
$0.00 |
| D1310 |
|
439 |
387 |
$0.00 |
| 90688 |
|
57 |
54 |
$0.00 |
| 96156 |
|
58 |
54 |
$0.00 |
| 90680 |
|
30 |
30 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |
| 36416 |
|
13 |
13 |
$0.00 |
| 90698 |
|
35 |
35 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
27 |
$0.00 |
| 90697 |
|
17 |
17 |
$0.00 |
| 85018 |
|
25 |
25 |
$0.00 |
| 90619 |
|
17 |
17 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
19 |
$0.00 |