| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
5,652 |
5,650 |
$113K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,419 |
19,001 |
$111K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,461 |
3,454 |
$109K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,973 |
2,968 |
$106K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,689 |
2,668 |
$102K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,437 |
1,402 |
$75K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,162 |
8,089 |
$71K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,445 |
3,326 |
$16K |
| 90461 |
|
2,945 |
2,939 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
92 |
$12K |
| 92552 |
|
7,162 |
7,148 |
$6K |
| 99188 |
|
247 |
247 |
$6K |
| 0071A |
|
131 |
131 |
$5K |
| 0072A |
|
119 |
119 |
$5K |
| 90480 |
|
76 |
76 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,388 |
1,359 |
$4K |
| 83655 |
|
715 |
708 |
$4K |
| D1206 |
Topical application of fluoride varnish |
927 |
926 |
$4K |
| 90680 |
|
214 |
205 |
$3K |
| 90670 |
|
331 |
330 |
$2K |
| 90698 |
|
298 |
297 |
$2K |
| 90686 |
|
627 |
626 |
$2K |
| 94060 |
|
530 |
466 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
33 |
33 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,635 |
1,600 |
$2K |
| 90651 |
|
50 |
50 |
$885.80 |
| 0074A |
|
20 |
20 |
$800.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
578 |
515 |
$737.94 |
| 90744 |
|
93 |
93 |
$671.00 |
| 85018 |
|
2,447 |
2,394 |
$383.93 |
| 90716 |
|
44 |
44 |
$163.00 |
| 90688 |
|
12 |
12 |
$111.50 |
| 90700 |
|
29 |
29 |
$83.00 |
| 90707 |
|
28 |
28 |
$82.00 |
| 90734 |
|
14 |
14 |
$36.00 |
| 90619 |
|
12 |
12 |
$27.00 |
| 90713 |
|
13 |
13 |
$19.00 |
| 81000 |
|
625 |
589 |
$14.20 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
434 |
374 |
$2.28 |
| 99173 |
|
4,533 |
4,529 |
$0.00 |
| 86580 |
|
14 |
14 |
$0.00 |
| 36416 |
|
33 |
33 |
$0.00 |
| 96150 |
|
122 |
122 |
$0.00 |
| 81005 |
|
83 |
75 |
$0.00 |