| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,558 |
3,397 |
$607K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
126 |
126 |
$21K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
222 |
222 |
$17K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
571 |
570 |
$5K |
| 90686 |
|
224 |
224 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
107 |
107 |
$2K |
| 81002 |
|
69 |
69 |
$182.16 |
| 82947 |
|
12 |
12 |
$48.60 |