| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
5,197 |
4,661 |
$1.05M |
| 0012A |
|
962 |
962 |
$41K |
| 0011A |
|
846 |
845 |
$30K |
| 97803 |
|
1,145 |
1,103 |
$29K |
| 0001A |
|
397 |
397 |
$18K |
| 0002A |
|
382 |
382 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
66 |
66 |
$15K |
| 97802 |
|
281 |
281 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
370 |
369 |
$8K |
| 90686 |
|
370 |
368 |
$6K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
55 |
55 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
284 |
283 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
76 |
76 |
$2K |
| 82947 |
|
406 |
401 |
$1K |
| 90750 |
|
13 |
13 |
$1K |
| 0064A |
|
25 |
25 |
$1K |
| 0004A |
|
25 |
25 |
$1K |
| 90715 |
|
24 |
24 |
$825.00 |
| 0134A |
|
12 |
12 |
$550.44 |
| 0071A |
|
12 |
12 |
$550.44 |
| 0124A |
|
12 |
12 |
$550.44 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
27 |
27 |
$305.04 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$155.82 |
| 91301 |
|
1,853 |
1,845 |
$0.03 |
| 91307 |
|
157 |
154 |
$0.00 |
| 91306 |
|
161 |
161 |
$0.00 |
| 91312 |
|
88 |
88 |
$0.00 |
| 91300 |
|
1,139 |
1,065 |
$0.00 |
| 91313 |
|
59 |
59 |
$0.00 |