| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,256 |
2,111 |
$365K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
121 |
121 |
$20K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
169 |
169 |
$13K |
| 90686 |
|
215 |
215 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
421 |
419 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
113 |
113 |
$2K |
| 90732 |
|
12 |
12 |
$1K |
| 81002 |
|
148 |
147 |
$388.69 |