| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,312 |
1,257 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,178 |
2,133 |
$90K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,073 |
1,053 |
$72K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
672 |
670 |
$43K |
| 99215 |
Prolong outpt/office vis |
378 |
367 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
493 |
488 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
426 |
426 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
203 |
202 |
$12K |
| 99051 |
|
198 |
195 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
108 |
108 |
$1K |
| 90686 |
|
262 |
260 |
$1K |
| 99188 |
|
57 |
57 |
$990.00 |
| 90670 |
|
112 |
110 |
$429.00 |
| 90648 |
|
109 |
107 |
$418.00 |
| 87428 |
|
16 |
16 |
$381.28 |
| 90688 |
|
19 |
19 |
$209.00 |
| 92551 |
|
624 |
622 |
$114.94 |
| 90723 |
|
25 |
24 |
$110.00 |
| 96160 |
|
167 |
167 |
$58.96 |
| 96127 |
|
196 |
195 |
$43.12 |
| 99173 |
|
77 |
77 |
$0.00 |
| G9920 |
Screening performed and negative |
169 |
169 |
$0.00 |
| 99177 |
|
196 |
196 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
115 |
115 |
$0.00 |
| 96161 |
|
199 |
199 |
$0.00 |
| 3008F |
|
144 |
144 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
47 |
47 |
$0.00 |