| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,313 |
1,880 |
$150K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
880 |
847 |
$84K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
725 |
630 |
$64K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,462 |
1,383 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
477 |
466 |
$46K |
| 92567 |
|
2,797 |
2,397 |
$33K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
270 |
268 |
$29K |
| D1206 |
Topical application of fluoride varnish |
1,079 |
1,068 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
224 |
213 |
$19K |
| 99188 |
|
1,085 |
1,074 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,663 |
1,594 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,053 |
950 |
$10K |
| 99058 |
|
572 |
539 |
$10K |
| 92587 |
|
1,200 |
1,190 |
$10K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
413 |
401 |
$9K |
| 87070 |
|
1,066 |
963 |
$8K |
| 36416 |
|
858 |
847 |
$4K |
| 85018 |
|
1,582 |
1,552 |
$3K |
| 94760 |
|
2,582 |
2,218 |
$3K |
| 99383 |
|
26 |
26 |
$3K |
| 97802 |
|
445 |
432 |
$3K |
| 85014 |
|
1,582 |
1,552 |
$2K |
| 99384 |
|
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
47 |
$941.60 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
55 |
53 |
$822.99 |
| 89190 |
|
147 |
136 |
$565.50 |
| 94664 |
|
70 |
65 |
$477.12 |
| 81002 |
|
174 |
162 |
$332.47 |
| 87807 |
|
20 |
17 |
$192.96 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
55 |
53 |
$45.36 |
| 96160 |
|
15 |
14 |
$40.08 |
| J7699 |
Noc drugs, inhalation solution administered through dme |
27 |
25 |
$18.40 |
| V5008 |
Hearing screening |
1,200 |
1,190 |
$5.32 |
| 99000 |
|
1,196 |
1,076 |
$2.18 |
| 99001 |
|
1,203 |
1,083 |
$1.45 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
27 |
25 |
$0.31 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
16 |
16 |
$0.14 |
| 90710 |
|
189 |
185 |
$0.00 |
| 90713 |
|
100 |
96 |
$0.00 |
| 90633 |
|
239 |
234 |
$0.00 |
| 87999 |
|
98 |
90 |
$0.00 |
| 90670 |
|
426 |
411 |
$0.00 |
| 90700 |
|
217 |
213 |
$0.00 |
| 90648 |
|
165 |
158 |
$0.00 |
| 90734 |
|
78 |
77 |
$0.00 |
| 90685 |
|
59 |
59 |
$0.00 |
| 90707 |
|
15 |
15 |
$0.00 |
| 90715 |
|
26 |
26 |
$0.00 |
| 90744 |
|
255 |
245 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
440 |
427 |
$0.00 |
| 90686 |
|
147 |
145 |
$0.00 |
| 90698 |
|
227 |
216 |
$0.00 |
| 90680 |
|
245 |
234 |
$0.00 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
14 |
14 |
$0.00 |
| 90696 |
|
14 |
14 |
$0.00 |
| 90651 |
|
27 |
27 |
$0.00 |