| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,522 |
3,218 |
$319K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,063 |
979 |
$94K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
864 |
781 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
783 |
672 |
$47K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,984 |
1,826 |
$37K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
626 |
588 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
152 |
144 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
158 |
150 |
$12K |
| D0145 |
Oral evaluation for a patient under three years of age |
232 |
230 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
726 |
708 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
316 |
281 |
$5K |
| D1206 |
Topical application of fluoride varnish |
232 |
230 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
19 |
14 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
150 |
77 |
$2K |
| 90651 |
|
144 |
118 |
$2K |
| 94200 |
|
90 |
75 |
$2K |
| 81002 |
|
2,239 |
2,111 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
322 |
290 |
$832.86 |
| 90474 |
|
40 |
40 |
$811.83 |
| 85018 |
|
2,381 |
2,286 |
$615.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
42 |
$579.33 |
| 90686 |
|
669 |
651 |
$383.68 |
| 90734 |
|
116 |
97 |
$357.03 |
| 96127 |
|
66 |
46 |
$290.48 |
| 92551 |
|
2,031 |
1,953 |
$248.43 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
13 |
$244.32 |
| 90621 |
|
31 |
25 |
$169.36 |
| 94760 |
|
511 |
434 |
$17.06 |
| 99000 |
|
728 |
665 |
$0.00 |
| 90680 |
|
40 |
40 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
12 |
12 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |
| 99173 |
|
2,121 |
2,037 |
$0.00 |
| 90670 |
|
74 |
74 |
$0.00 |
| 90715 |
|
26 |
15 |
$0.00 |