| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
2,550 |
2,442 |
$429K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
327 |
324 |
$57K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
364 |
357 |
$27K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
984 |
972 |
$9K |
| 90686 |
|
134 |
134 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
63 |
$1K |
| 81002 |
|
198 |
196 |
$515.09 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$158.73 |