| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,197 |
842 |
$90K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,790 |
1,297 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
430 |
264 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
112 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
492 |
189 |
$9K |
| 96127 |
|
388 |
269 |
$6K |
| 90686 |
|
654 |
474 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
49 |
43 |
$4K |
| 83655 |
|
335 |
193 |
$4K |
| 36416 |
|
1,179 |
563 |
$4K |
| D1206 |
Topical application of fluoride varnish |
114 |
57 |
$3K |
| 90670 |
|
35 |
14 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
270 |
198 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
131 |
55 |
$2K |
| 85018 |
|
864 |
529 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
24 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,272 |
556 |
$2K |
| 90672 |
|
54 |
32 |
$560.64 |
| 94664 |
|
33 |
12 |
$445.36 |
| G0008 |
Administration of influenza virus vaccine |
78 |
69 |
$441.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
16 |
$321.85 |
| 94760 |
|
115 |
72 |
$291.17 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
34 |
12 |
$275.60 |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
38 |
12 |
$167.25 |
| 36415 |
Collection of venous blood by venipuncture |
34 |
26 |
$133.66 |
| 90698 |
|
13 |
13 |
$83.20 |
| 82948 |
|
31 |
13 |
$55.68 |
| A7015 |
Aerosol mask, used with dme nebulizer |
34 |
12 |
$54.90 |
| 90461 |
|
97 |
44 |
$33.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
34 |
12 |
$1.76 |