| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,605 |
1,206 |
$165K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
351 |
192 |
$212.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,481 |
672 |
$141.75 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
12 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
17 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21 |
13 |
$0.00 |