| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17 |
17 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
51 |
50 |
$929.73 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
35 |
35 |
$679.91 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
51 |
50 |
$496.23 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
51 |
50 |
$461.55 |