| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,745 |
5,733 |
$947K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,650 |
3,192 |
$161K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
376 |
358 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
242 |
225 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
290 |
280 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
82 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,272 |
1,122 |
$10K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
497 |
461 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
95 |
94 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
539 |
480 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
349 |
180 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$2K |
| 99384 |
|
15 |
15 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$244.24 |
| 90686 |
|
61 |
61 |
$150.03 |
| 87807 |
|
12 |
12 |
$99.00 |
| 90461 |
|
16 |
12 |
$80.52 |
| 81003 |
|
72 |
70 |
$79.38 |
| 90656 |
|
24 |
24 |
$17.47 |
| 90651 |
|
30 |
30 |
$0.00 |
| 3074F |
|
78 |
69 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
129 |
128 |
$0.00 |
| 92551 |
|
122 |
120 |
$0.00 |
| 3079F |
|
36 |
30 |
$0.00 |
| 96127 |
|
16 |
16 |
$0.00 |
| 99173 |
|
124 |
121 |
$0.00 |
| 3078F |
|
17 |
17 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
45 |
36 |
$0.00 |