| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,808 |
1,772 |
$291K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
129 |
129 |
$22K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
276 |
276 |
$21K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
590 |
590 |
$5K |
| 90686 |
|
191 |
191 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
94 |
94 |
$2K |
| 90715 |
|
12 |
12 |
$388.08 |