| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
41 |
39 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
19 |
19 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
19 |
19 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
94 |
94 |
$850.70 |
| 99173 |
|
12 |
12 |
$283.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$143.78 |
| 92551 |
|
13 |
13 |
$123.76 |