| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
1,026 |
998 |
$219K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
63 |
$14K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
38 |
38 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
239 |
239 |
$2K |
| 90686 |
|
38 |
38 |
$710.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$572.60 |