| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,255 |
1,244 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,203 |
2,919 |
$102K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,124 |
1,106 |
$92K |
| 99215 |
Prolong outpt/office vis |
1,535 |
1,395 |
$82K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,287 |
2,231 |
$58K |
| 99354 |
|
670 |
657 |
$57K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
473 |
466 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
732 |
710 |
$16K |
| S8301 |
Infection control supplies, not otherwise specified |
4,596 |
3,771 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,223 |
862 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
87 |
$8K |
| 90461 |
|
1,533 |
1,353 |
$8K |
| 99429 |
|
119 |
118 |
$4K |
| 99381 |
|
48 |
48 |
$4K |
| 99417 |
Prolong home eval add 15m |
381 |
361 |
$3K |
| 99050 |
|
42 |
40 |
$1K |
| 99000 |
|
115 |
107 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
16 |
$429.51 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
46 |
46 |
$294.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$183.36 |
| 90686 |
|
503 |
503 |
$60.55 |
| 90677 |
|
136 |
136 |
$0.23 |
| 90670 |
|
732 |
725 |
$0.00 |
| 90633 |
|
122 |
122 |
$0.00 |
| 99401 |
|
19 |
19 |
$0.00 |
| 90710 |
|
78 |
78 |
$0.00 |
| 99051 |
|
13 |
13 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 96127 |
|
154 |
136 |
$0.00 |
| 90680 |
|
497 |
492 |
$0.00 |
| 90647 |
|
514 |
509 |
$0.00 |
| 90723 |
|
179 |
176 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |