| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
520 |
445 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
184 |
180 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
400 |
387 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
167 |
149 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
107 |
103 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
49 |
$5K |
| 92015 |
Determination of refractive state |
90 |
88 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
160 |
150 |
$2K |
| 99188 |
|
184 |
179 |
$2K |
| 92587 |
|
69 |
67 |
$1K |
| 99401 |
|
37 |
37 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18 |
18 |
$492.02 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
19 |
17 |
$402.22 |
| 92567 |
|
29 |
28 |
$336.81 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
49 |
$314.50 |
| 94667 |
|
12 |
12 |
$123.24 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$88.50 |
| 94760 |
|
36 |
35 |
$65.25 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$14.82 |
| A7015 |
Aerosol mask, used with dme nebulizer |
12 |
12 |
$8.76 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
12 |
12 |
$6.66 |
| 90633 |
|
36 |
35 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90670 |
|
120 |
117 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90647 |
|
27 |
27 |
$0.00 |
| 90680 |
|
28 |
27 |
$0.00 |
| 97802 |
|
13 |
12 |
$0.00 |
| 90698 |
|
16 |
16 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90723 |
|
13 |
12 |
$0.00 |
| 90688 |
|
34 |
34 |
$0.00 |