| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,513 |
9,245 |
$946K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,178 |
1,046 |
$31K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
110 |
98 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
120 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
43 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,083 |
483 |
$367.70 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
101 |
98 |
$8.75 |
| 90686 |
|
13 |
13 |
$2.00 |
| 3074F |
|
148 |
131 |
$0.00 |
| 3008F |
|
402 |
352 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
37 |
37 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
23 |
23 |
$0.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| 1160F |
|
318 |
282 |
$0.00 |
| 3078F |
|
126 |
119 |
$0.00 |
| 90461 |
|
191 |
155 |
$0.00 |
| 1159F |
|
297 |
265 |
$0.00 |
| 90734 |
|
14 |
12 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |