| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
646 |
554 |
$147K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
414 |
371 |
$1K |
| 87428 |
|
86 |
83 |
$571.28 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
112 |
106 |
$163.17 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
47 |
$117.88 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
45 |
45 |
$106.36 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
61 |
$88.45 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
61 |
61 |
$23.92 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
47 |
$17.94 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
13 |
$0.00 |
| 90677 |
|
34 |
34 |
$0.00 |
| 90474 |
|
26 |
26 |
$0.00 |