| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,420 |
3,845 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,736 |
1,732 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,069 |
2,064 |
$18K |
| 92552 |
|
1,039 |
1,039 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
684 |
683 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,346 |
7,569 |
$3K |
| 99173 |
|
1,049 |
1,049 |
$2K |
| 83026 |
|
647 |
647 |
$2K |
| 90658 |
|
1,144 |
1,141 |
$1K |
| 92081 |
|
4,157 |
4,152 |
$1K |
| 92551 |
|
4,047 |
4,042 |
$1K |
| 81003 |
|
392 |
392 |
$905.58 |
| 97802 |
|
4,062 |
4,056 |
$872.43 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
4,001 |
3,996 |
$677.25 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
86 |
86 |
$352.82 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$198.00 |
| 90686 |
|
151 |
148 |
$167.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$120.00 |
| 90651 |
|
138 |
138 |
$110.00 |
| 90734 |
|
37 |
37 |
$81.00 |
| 90716 |
|
36 |
36 |
$60.00 |
| 85018 |
|
2,248 |
2,244 |
$52.17 |
| 90700 |
|
38 |
38 |
$18.00 |
| 96127 |
|
931 |
929 |
$14.00 |
| 81002 |
|
184 |
184 |
$10.32 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
365 |
364 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
68 |
68 |
$0.00 |
| 3074F |
|
345 |
319 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
94 |
94 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 3078F |
|
333 |
308 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |