| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
470 |
451 |
$74K |
| S9083 |
Global fee urgent care centers |
264 |
263 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
47 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
182 |
182 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
18 |
18 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
321 |
316 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
253 |
249 |
$3K |
| 99173 |
|
114 |
113 |
$2K |
| 92551 |
|
117 |
117 |
$1K |
| 99188 |
|
31 |
31 |
$806.00 |
| 90670 |
|
17 |
17 |
$576.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
41 |
$484.21 |
| 81025 |
|
27 |
27 |
$176.04 |
| 85018 |
|
45 |
45 |
$109.80 |
| 81002 |
|
16 |
16 |
$42.24 |
| 90686 |
|
23 |
23 |
$38.06 |
| 90633 |
|
33 |
33 |
$0.00 |