| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
28,593 |
23,123 |
$6.80M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,639 |
2,623 |
$606K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,145 |
2,059 |
$492K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,670 |
1,656 |
$395K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
674 |
659 |
$150K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,684 |
2,525 |
$30K |
| 90686 |
|
662 |
656 |
$11K |
| 81002 |
|
271 |
220 |
$8K |
| 99381 |
|
41 |
39 |
$8K |
| 99383 |
|
36 |
36 |
$8K |
| 99382 |
|
12 |
12 |
$3K |
| 90710 |
|
769 |
762 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
81 |
$1K |
| 90700 |
|
291 |
287 |
$1K |
| CP005 |
|
74 |
62 |
$1K |
| 90697 |
|
222 |
221 |
$1K |
| 90633 |
|
940 |
936 |
$974.40 |
| 90677 |
|
427 |
421 |
$774.51 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,896 |
1,878 |
$747.42 |
| 81003 |
|
23 |
16 |
$730.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
13 |
$519.86 |
| 90734 |
|
227 |
225 |
$497.44 |
| 90670 |
|
1,358 |
1,340 |
$492.32 |
| 90723 |
|
594 |
586 |
$492.32 |
| 90698 |
|
220 |
215 |
$487.20 |
| 90681 |
|
705 |
693 |
$258.17 |
| 90656 |
|
30 |
29 |
$258.17 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
164 |
164 |
$256.52 |
| 90696 |
|
133 |
131 |
$248.72 |
| 90648 |
|
972 |
958 |
$243.60 |
| 90715 |
|
48 |
46 |
$243.60 |
| 90651 |
|
57 |
56 |
$240.24 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,428 |
1,258 |
$15.68 |
| 90461 |
|
4,808 |
1,605 |
$0.00 |
| 3078F |
|
152 |
149 |
$0.00 |
| 90621 |
|
100 |
99 |
$0.00 |
| 99173 |
|
57 |
55 |
$0.00 |
| 90380 |
|
39 |
39 |
$0.00 |
| 3008F |
|
2,451 |
2,359 |
$0.00 |
| 3074F |
|
306 |
300 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
56 |
41 |
$0.00 |