| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
31,812 |
23,373 |
$2.50M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,366 |
1,110 |
$111K |
| 99199 |
Unlisted special service, procedure or report |
31,115 |
30,386 |
$105K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,695 |
5,360 |
$64K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
441 |
408 |
$36K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,099 |
1,018 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,451 |
1,319 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,305 |
1,911 |
$22K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,416 |
2,190 |
$15K |
| 81003 |
|
4,927 |
3,167 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
290 |
265 |
$4K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
64 |
56 |
$4K |
| 81025 |
|
515 |
447 |
$3K |
| 90474 |
|
200 |
193 |
$3K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
77 |
63 |
$2K |
| 96161 |
|
296 |
270 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
246 |
145 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
25 |
$364.25 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$323.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$174.84 |
| 81000 |
|
23 |
16 |
$76.57 |
| 99173 |
|
59 |
53 |
$25.81 |
| 92551 |
|
42 |
40 |
$1.00 |
| 90670 |
|
430 |
410 |
$0.00 |
| 90633 |
|
27 |
25 |
$0.00 |
| 99307 |
|
43 |
41 |
$0.00 |
| 90685 |
|
60 |
57 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
354 |
279 |
$0.00 |
| 90680 |
|
276 |
264 |
$0.00 |
| 90647 |
|
85 |
83 |
$0.00 |
| 90698 |
|
149 |
137 |
$0.00 |
| 90677 |
|
44 |
43 |
$0.00 |
| 90744 |
|
13 |
12 |
$0.00 |
| 90686 |
|
26 |
25 |
$0.00 |
| 90723 |
|
60 |
58 |
$0.00 |
| 99174 |
|
15 |
12 |
$0.00 |