| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,832 |
3,027 |
$193K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,659 |
1,112 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
980 |
666 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
810 |
558 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
857 |
549 |
$49K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,557 |
1,073 |
$32K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,663 |
926 |
$25K |
| 92587 |
|
1,030 |
794 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,519 |
1,044 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
199 |
133 |
$13K |
| 95115 |
|
1,446 |
465 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
146 |
108 |
$11K |
| 87807 |
|
1,083 |
701 |
$9K |
| 99177 |
|
1,456 |
992 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
82 |
56 |
$5K |
| 96127 |
|
724 |
505 |
$4K |
| 81003 |
|
1,278 |
889 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
126 |
72 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
93 |
87 |
$1K |
| 3008F |
|
67 |
33 |
$620.00 |
| 90686 |
|
386 |
335 |
$617.07 |
| 99173 |
|
116 |
61 |
$470.61 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
42 |
15 |
$429.07 |
| 90670 |
|
556 |
384 |
$185.00 |
| 90716 |
|
239 |
152 |
$180.73 |
| 90707 |
|
236 |
151 |
$104.37 |
| 90461 |
|
91 |
81 |
$66.22 |
| 90633 |
|
210 |
134 |
$42.42 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
102 |
54 |
$6.94 |
| 90680 |
|
245 |
153 |
$0.00 |
| 90723 |
|
323 |
208 |
$0.00 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
19 |
15 |
$0.00 |
| 90651 |
|
108 |
59 |
$0.00 |
| 90648 |
|
565 |
372 |
$0.00 |
| 90700 |
|
26 |
12 |
$0.00 |
| 90734 |
|
37 |
16 |
$0.00 |
| 90715 |
|
35 |
15 |
$0.00 |