| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,836 |
1,301 |
$244K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
389 |
248 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
34 |
27 |
$0.00 |
| 3008F |
|
1,550 |
849 |
$0.00 |
| 92551 |
|
154 |
129 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
15 |
$0.00 |
| 85018 |
|
222 |
174 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20 |
16 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,871 |
1,070 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
394 |
206 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
337 |
187 |
$0.00 |
| 99173 |
|
182 |
153 |
$0.00 |
| 99188 |
|
86 |
68 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
22 |
$0.00 |
| 81003 |
|
281 |
200 |
$0.00 |
| 81025 |
|
38 |
30 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
19 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$0.00 |