| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
4,196 |
3,950 |
$723K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
670 |
670 |
$121K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
647 |
647 |
$116K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,630 |
2,600 |
$99K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
267 |
266 |
$45K |
| 99173 |
|
1,968 |
1,968 |
$45K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,924 |
2,913 |
$30K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,989 |
2,978 |
$27K |
| 92551 |
|
1,945 |
1,945 |
$19K |
| 99188 |
|
726 |
726 |
$19K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
57 |
57 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
89 |
89 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
24 |
$5K |
| 96127 |
|
221 |
219 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
173 |
172 |
$2K |
| 90651 |
|
193 |
193 |
$2K |
| 90686 |
|
1,365 |
1,364 |
$1K |
| 85018 |
|
460 |
460 |
$1K |
| 87634 |
|
13 |
13 |
$804.96 |
| 0124A |
|
16 |
16 |
$733.92 |
| 97803 |
|
16 |
14 |
$407.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
24 |
$293.52 |
| 90649 |
|
30 |
29 |
$137.59 |
| 90633 |
|
134 |
134 |
$47.88 |
| 81002 |
|
18 |
18 |
$47.52 |
| 91307 |
|
26 |
26 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 91305 |
|
17 |
17 |
$0.00 |
| 91312 |
|
30 |
30 |
$0.00 |
| 90734 |
|
80 |
80 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |