| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,861 |
2,506 |
$162K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
658 |
579 |
$55K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
579 |
576 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
185 |
185 |
$698.60 |
| 90734 |
|
26 |
26 |
$227.02 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
438 |
364 |
$222.96 |
| 90688 |
|
99 |
99 |
$211.17 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
89 |
89 |
$82.05 |
| 90686 |
|
72 |
72 |
$46.59 |
| 82947 |
|
16 |
16 |
$5.35 |
| 90715 |
|
25 |
25 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |