| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
456 |
386 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
523 |
413 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
63 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 90686 |
|
93 |
89 |
$397.97 |
| 3008F |
|
156 |
151 |
$23.49 |
| 90620 |
|
30 |
29 |
$20.00 |
| 90734 |
|
18 |
18 |
$10.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
282 |
267 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
105 |
98 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
27 |
25 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
22 |
19 |
$0.00 |
| 97803 |
|
135 |
133 |
$0.00 |
| 90461 |
|
53 |
53 |
$0.00 |
| 94664 |
|
27 |
25 |
$0.00 |
| 99173 |
|
89 |
87 |
$0.00 |
| 90649 |
|
13 |
13 |
$0.00 |
| 92551 |
|
90 |
88 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
27 |
25 |
$0.00 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
13 |
12 |
$0.00 |