| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,668 |
3,519 |
$1.45M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,021 |
3,557 |
$148K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
857 |
784 |
$25K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
416 |
404 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
37 |
27 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
24 |
24 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
177 |
174 |
$519.26 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
44 |
44 |
$508.23 |
| 0011A |
|
13 |
13 |
$246.12 |
| 92551 |
|
30 |
30 |
$213.75 |
| 0012A |
|
13 |
13 |
$170.99 |
| 3008F |
|
19 |
19 |
$170.00 |
| D1120 |
Prophylaxis - child |
13 |
13 |
$125.00 |
| 90686 |
|
30 |
30 |
$114.48 |
| 81002 |
|
62 |
58 |
$102.03 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$100.00 |
| 99173 |
|
46 |
46 |
$54.80 |
| 92587 |
|
15 |
15 |
$43.96 |
| D0602 |
|
14 |
14 |
$20.00 |
| 90832 |
Psychotherapy, 30 minutes with patient |
5,171 |
2,399 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
132 |
132 |
$0.00 |
| 90834 |
Psychotherapy, 45 minutes with patient |
232 |
140 |
$0.00 |
| 90674 |
|
14 |
14 |
$0.00 |