| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,257 |
1,251 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,038 |
1,009 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
622 |
618 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
458 |
451 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,745 |
3,298 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,286 |
1,122 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,627 |
1,112 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
308 |
304 |
$10K |
| 92552 |
|
546 |
544 |
$5K |
| 92551 |
|
379 |
379 |
$4K |
| 90686 |
|
951 |
909 |
$3K |
| 96156 |
|
30 |
30 |
$2K |
| 96150 |
|
227 |
227 |
$2K |
| 85014 |
|
569 |
554 |
$1K |
| 85018 |
|
568 |
560 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
610 |
605 |
$941.36 |
| 90670 |
|
251 |
251 |
$549.00 |
| 83655 |
|
24 |
24 |
$452.28 |
| 90685 |
|
44 |
33 |
$311.58 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
139 |
139 |
$274.86 |
| 92081 |
|
943 |
940 |
$264.11 |
| 99173 |
|
85 |
85 |
$247.28 |
| 90651 |
|
30 |
30 |
$215.00 |
| 90698 |
|
103 |
103 |
$189.00 |
| 90734 |
|
70 |
70 |
$126.00 |
| 81002 |
|
83 |
83 |
$105.72 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
124 |
124 |
$101.57 |
| 90744 |
|
39 |
39 |
$90.00 |
| 90715 |
|
12 |
12 |
$87.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
39 |
39 |
$50.52 |
| 90707 |
|
89 |
89 |
$45.00 |
| 90633 |
|
63 |
62 |
$45.00 |
| 90716 |
|
78 |
78 |
$36.00 |
| 90461 |
|
226 |
200 |
$32.32 |
| 3008F |
|
152 |
152 |
$0.00 |
| 96161 |
|
12 |
12 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
15 |
15 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
40 |
40 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
18 |
$0.00 |