| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,745 |
9,543 |
$3.97M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,813 |
3,098 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,914 |
2,339 |
$7K |
| 90734 |
|
21 |
15 |
$1K |
| 90674 |
|
294 |
221 |
$833.26 |
| 99215 |
Prolong outpt/office vis |
510 |
425 |
$628.45 |
| 90715 |
|
157 |
114 |
$582.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,016 |
1,464 |
$541.69 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
322 |
251 |
$456.10 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
149 |
119 |
$370.64 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
93 |
62 |
$330.85 |
| 90756 |
|
370 |
282 |
$188.20 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
118 |
98 |
$65.60 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
154 |
119 |
$64.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
495 |
377 |
$41.33 |
| 99383 |
|
20 |
16 |
$0.00 |
| 90686 |
|
25 |
25 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
56 |
43 |
$0.00 |
| 90633 |
|
32 |
24 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
25 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$0.00 |