| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,953 |
3,773 |
$683K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
303 |
302 |
$55K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
243 |
242 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,036 |
1,033 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
227 |
227 |
$5K |
| 90686 |
|
183 |
183 |
$3K |
| 90732 |
|
26 |
26 |
$3K |
| 90715 |
|
68 |
68 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$219.78 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$183.45 |
| 81002 |
|
43 |
41 |
$112.61 |
| 82947 |
|
15 |
15 |
$60.75 |