| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,300 |
2,922 |
$809K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
189 |
188 |
$50K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
106 |
99 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
71 |
70 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
50 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
43 |
41 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,248 |
1,208 |
$2K |
| 90686 |
|
181 |
179 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,036 |
634 |
$505.26 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
69 |
$49.68 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
13 |
$43.29 |
| 90670 |
|
78 |
76 |
$0.00 |
| 3725F |
|
21 |
21 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
63 |
62 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 1160F |
|
36 |
36 |
$0.00 |
| 3078F |
|
17 |
17 |
$0.00 |
| 96127 |
|
98 |
89 |
$0.00 |
| 3008F |
|
35 |
35 |
$0.00 |
| 1036F |
|
36 |
36 |
$0.00 |
| 3074F |
|
17 |
17 |
$0.00 |