| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
165 |
137 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23 |
22 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
81 |
80 |
$643.72 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46 |
44 |
$550.56 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$31.78 |
| 90677 |
|
22 |
22 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
40 |
$0.00 |
| 90648 |
|
16 |
16 |
$0.00 |