| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96156 |
|
722 |
710 |
$2K |
| 97802 |
|
1,025 |
1,015 |
$1K |
| 92552 |
|
1,254 |
1,252 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
209 |
207 |
$600.77 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,768 |
3,477 |
$513.26 |
| 90686 |
|
396 |
396 |
$469.75 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$444.24 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
587 |
283 |
$110.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,484 |
1,131 |
$63.02 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,256 |
1,165 |
$45.00 |
| 96150 |
|
65 |
65 |
$18.03 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
107 |
$18.00 |
| 99173 |
|
1,149 |
1,147 |
$6.91 |
| 81000 |
|
30 |
30 |
$2.58 |
| 99441 |
|
93 |
89 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
30 |
30 |
$0.00 |
| 96127 |
|
395 |
392 |
$0.00 |
| 96151 |
|
82 |
81 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
30 |
30 |
$0.00 |
| 90674 |
|
37 |
37 |
$0.00 |
| G9920 |
Screening performed and negative |
163 |
163 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
36 |
$0.00 |
| 97803 |
|
53 |
53 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
27 |
$0.00 |
| 99072 |
|
59 |
57 |
$0.00 |