| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
15,758 |
13,694 |
$922K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,196 |
5,706 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,161 |
5,590 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,054 |
1,047 |
$6K |
| 90686 |
|
737 |
737 |
$4K |
| 90671 |
|
81 |
81 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
239 |
239 |
$3K |
| 87428 |
|
169 |
168 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
871 |
858 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
83 |
80 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
73 |
73 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76 |
76 |
$779.79 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
56 |
56 |
$615.75 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
40 |
$606.08 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
62 |
$570.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
276 |
259 |
$462.04 |
| 96127 |
|
645 |
489 |
$377.45 |
| 90656 |
|
62 |
62 |
$334.15 |
| 90480 |
|
13 |
12 |
$279.86 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
39 |
33 |
$92.26 |
| 90715 |
|
12 |
12 |
$76.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
55 |
53 |
$73.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28 |
27 |
$30.13 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
17 |
16 |
$29.26 |
| 81003 |
|
50 |
50 |
$16.83 |
| 90461 |
|
104 |
104 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 87807 |
|
13 |
13 |
$0.00 |