| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,024 |
3,651 |
$241K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,574 |
1,720 |
$191K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,987 |
1,225 |
$157K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,702 |
1,190 |
$134K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,005 |
712 |
$71K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
787 |
554 |
$69K |
| D1206 |
Topical application of fluoride varnish |
1,520 |
940 |
$41K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,954 |
972 |
$35K |
| 90670 |
|
942 |
669 |
$27K |
| 96127 |
|
1,360 |
1,053 |
$20K |
| 83655 |
|
1,633 |
983 |
$20K |
| 90686 |
|
2,317 |
1,682 |
$17K |
| 36416 |
|
4,209 |
2,300 |
$14K |
| 90698 |
|
918 |
629 |
$13K |
| 90651 |
|
373 |
216 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,059 |
784 |
$11K |
| 85018 |
|
3,946 |
2,557 |
$9K |
| 90680 |
|
458 |
337 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,891 |
2,086 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
354 |
152 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
410 |
198 |
$5K |
| 90633 |
|
407 |
229 |
$3K |
| 94664 |
|
278 |
147 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
553 |
457 |
$3K |
| 90672 |
|
290 |
190 |
$3K |
| 0001A |
|
61 |
59 |
$3K |
| 90744 |
|
274 |
171 |
$2K |
| 90734 |
|
185 |
113 |
$2K |
| 0081A |
|
48 |
44 |
$2K |
| 86580 |
|
359 |
231 |
$2K |
| 90685 |
|
210 |
123 |
$2K |
| 0071A |
|
37 |
35 |
$2K |
| 96160 |
|
139 |
59 |
$2K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
377 |
171 |
$1K |
| 0124A |
|
32 |
32 |
$1K |
| 99381 |
|
14 |
12 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
360 |
208 |
$1K |
| 0073A |
|
28 |
27 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
54 |
$1K |
| 0002A |
|
23 |
22 |
$969.22 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
12 |
$740.35 |
| 94760 |
|
351 |
206 |
$734.03 |
| 90461 |
|
1,717 |
815 |
$718.89 |
| A7015 |
Aerosol mask, used with dme nebulizer |
383 |
191 |
$522.53 |
| 90696 |
|
65 |
28 |
$416.00 |
| 90710 |
|
65 |
28 |
$416.00 |
| 90715 |
|
58 |
29 |
$217.60 |
| 90716 |
|
19 |
14 |
$115.20 |
| 90707 |
|
18 |
13 |
$108.80 |
| 99174 |
|
15 |
15 |
$82.70 |
| G0010 |
Administration of hepatitis b vaccine |
24 |
15 |
$64.64 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
324 |
160 |
$34.15 |
| 96161 |
|
28 |
12 |
$0.00 |
| 99177 |
|
155 |
76 |
$0.00 |
| 90473 |
|
51 |
42 |
$0.00 |