| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
880 |
839 |
$140K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
50 |
50 |
$8K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
69 |
69 |
$5K |
| 90686 |
|
201 |
201 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
216 |
216 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
48 |
$981.60 |
| 81002 |
|
209 |
208 |
$551.76 |
| 81025 |
|
27 |
27 |
$176.04 |