| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
6,064 |
5,725 |
$1.05M |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
218 |
217 |
$39K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
491 |
490 |
$37K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,082 |
1,080 |
$10K |
| 90686 |
|
501 |
501 |
$10K |
| 90750 |
|
87 |
87 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
158 |
158 |
$3K |
| 90715 |
|
70 |
70 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
87 |
87 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
17 |
$212.58 |
| 81002 |
|
27 |
27 |
$70.30 |
| 91300 |
|
44 |
44 |
$0.00 |