| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
123 |
123 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
106 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
107 |
105 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
88 |
88 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
32 |
$3K |
| 90461 |
|
30 |
30 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
109 |
109 |
$986.45 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
81 |
78 |
$883.22 |
| 96127 |
|
26 |
26 |
$277.29 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
12 |
$202.30 |
| 94760 |
|
15 |
15 |
$29.70 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
12 |
12 |
$21.00 |