| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,016 |
1,908 |
$326K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
107 |
107 |
$18K |
| 90732 |
|
87 |
87 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
102 |
102 |
$8K |
| 90715 |
|
235 |
235 |
$8K |
| 90686 |
|
278 |
278 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
223 |
223 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
424 |
423 |
$4K |
| 90750 |
|
39 |
39 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
42 |
42 |
$472.32 |
| 82947 |
|
103 |
99 |
$411.91 |