| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
131 |
116 |
$194.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
670 |
621 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
158 |
$0.00 |
| 90686 |
|
54 |
54 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
13 |
13 |
$0.00 |
| 92583 |
|
13 |
13 |
$0.00 |
| J7609 |
Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg |
14 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
145 |
143 |
$0.00 |
| 99173 |
|
342 |
341 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
144 |
144 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
62 |
62 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
167 |
166 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
14 |
12 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
13 |
12 |
$0.00 |