| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
3,047 |
2,810 |
$494K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
354 |
350 |
$27K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
113 |
112 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
726 |
719 |
$7K |
| 90686 |
|
173 |
173 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
140 |
139 |
$3K |
| 90715 |
|
42 |
42 |
$1K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
122 |
122 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
64 |
64 |
$781.44 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
49 |
$599.27 |
| 81002 |
|
63 |
63 |
$166.32 |
| 93000 |
|
12 |
12 |
$162.12 |
| 81025 |
|
13 |
12 |
$84.76 |