| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,473 |
2,105 |
$120K |
| 90700 |
|
16 |
16 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
487 |
310 |
$0.00 |
| 90648 |
|
157 |
157 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
253 |
248 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
112 |
112 |
$0.00 |
| 90670 |
|
151 |
151 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
21 |
21 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$0.00 |
| 90681 |
|
69 |
69 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 99382 |
|
53 |
53 |
$0.00 |
| 90633 |
|
29 |
29 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,001 |
860 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
468 |
466 |
$0.00 |
| 99383 |
|
81 |
81 |
$0.00 |
| 90474 |
|
98 |
98 |
$0.00 |
| 99381 |
|
54 |
54 |
$0.00 |
| 90723 |
|
126 |
126 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
159 |
144 |
$0.00 |
| 90688 |
|
67 |
67 |
$0.00 |
| 92551 |
|
13 |
13 |
$0.00 |
| 90686 |
|
64 |
64 |
$0.00 |
| 85018 |
|
26 |
26 |
$0.00 |