| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,053 |
992 |
$105K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,065 |
2,034 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,193 |
1,113 |
$81K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
614 |
608 |
$63K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
485 |
455 |
$46K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
383 |
376 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
116 |
116 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
288 |
137 |
$3K |
| 90461 |
|
546 |
540 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
152 |
151 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
46 |
45 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 92587 |
|
182 |
181 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
147 |
145 |
$1K |
| 92551 |
|
217 |
214 |
$542.18 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
34 |
31 |
$514.64 |
| 94760 |
|
391 |
360 |
$510.56 |
| 99188 |
|
39 |
39 |
$478.47 |
| 96127 |
|
40 |
40 |
$173.52 |
| 36416 |
|
38 |
38 |
$114.77 |
| 96161 |
|
13 |
13 |
$53.17 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
34 |
31 |
$21.63 |
| 94761 |
|
20 |
19 |
$20.75 |
| A7015 |
Aerosol mask, used with dme nebulizer |
34 |
31 |
$15.00 |
| 90670 |
|
150 |
150 |
$0.00 |
| 99173 |
|
267 |
267 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 97802 |
|
282 |
279 |
$0.00 |
| 90698 |
|
67 |
67 |
$0.00 |
| 90686 |
|
457 |
450 |
$0.00 |
| 90680 |
|
41 |
41 |
$0.00 |
| 99000 |
|
353 |
349 |
$0.00 |
| 90656 |
|
36 |
36 |
$0.00 |