| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,779 |
4,739 |
$214K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,248 |
2,081 |
$213K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,072 |
2,884 |
$206K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,034 |
2,009 |
$205K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,067 |
1,057 |
$107K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,393 |
2,302 |
$95K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
527 |
504 |
$52K |
| Q3014 |
Telehealth originating site facility fee |
1,609 |
1,547 |
$37K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
238 |
237 |
$26K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
963 |
954 |
$20K |
| 99188 |
|
1,225 |
1,211 |
$14K |
| 92567 |
|
636 |
599 |
$8K |
| 99070 |
|
576 |
554 |
$5K |
| 99401 |
|
784 |
777 |
$4K |
| D1206 |
Topical application of fluoride varnish |
58 |
53 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
343 |
337 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
104 |
$2K |
| 96127 |
|
351 |
348 |
$2K |
| 99177 |
|
718 |
710 |
$2K |
| 90686 |
|
1,225 |
1,217 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
172 |
169 |
$1K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
62 |
61 |
$996.13 |
| 94780 |
|
12 |
12 |
$531.64 |
| 90680 |
|
823 |
818 |
$364.46 |
| 36416 |
|
55 |
55 |
$225.54 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
12 |
$170.45 |
| 87275 |
|
12 |
12 |
$98.16 |
| 87276 |
|
12 |
12 |
$98.16 |
| 90647 |
|
186 |
186 |
$88.88 |
| 94664 |
|
13 |
12 |
$15.43 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13 |
12 |
$14.82 |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
12 |
$10.14 |
| J7610 |
Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg |
13 |
12 |
$6.66 |
| 90677 |
|
133 |
132 |
$1.32 |
| 90700 |
|
106 |
102 |
$0.00 |
| 90648 |
|
16 |
14 |
$0.00 |
| 90670 |
|
1,365 |
1,355 |
$0.00 |
| 90710 |
|
297 |
293 |
$0.00 |
| 90633 |
|
497 |
493 |
$0.00 |
| 90734 |
|
37 |
36 |
$0.00 |
| 90685 |
|
96 |
96 |
$0.00 |
| 90681 |
|
16 |
16 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$0.00 |
| 87400 |
|
12 |
12 |
$0.00 |
| 90698 |
|
545 |
542 |
$0.00 |
| 90723 |
|
82 |
82 |
$0.00 |
| 90744 |
|
103 |
101 |
$0.00 |
| 90696 |
|
28 |
28 |
$0.00 |
| 99000 |
|
82 |
80 |
$0.00 |
| 91307 |
|
34 |
33 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |