| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,515 |
3,111 |
$701K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
1,946 |
1,651 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
249 |
220 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
21 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$3K |
| 11721 |
|
409 |
408 |
$223.03 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
15 |
15 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
20 |
$0.00 |
| 90461 |
|
16 |
15 |
$0.00 |