| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90658 |
|
2,564 |
2,555 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
624 |
617 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
695 |
686 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,946 |
10,545 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
251 |
250 |
$9K |
| 90649 |
|
309 |
309 |
$3K |
| 90744 |
|
248 |
248 |
$2K |
| 92081 |
|
157 |
157 |
$2K |
| 90620 |
|
196 |
196 |
$2K |
| 92552 |
|
126 |
126 |
$2K |
| 90734 |
|
174 |
174 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
172 |
169 |
$1K |
| 90633 |
|
127 |
127 |
$1K |
| 90688 |
|
38 |
37 |
$951.34 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
537 |
533 |
$934.44 |
| 90715 |
|
50 |
50 |
$523.51 |
| 90686 |
|
263 |
262 |
$501.39 |
| 90710 |
|
44 |
44 |
$378.47 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
94 |
94 |
$293.88 |
| 90746 |
|
12 |
12 |
$229.22 |
| 90657 |
|
24 |
24 |
$226.80 |
| 90698 |
|
14 |
14 |
$113.40 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
79 |
78 |
$111.13 |
| 90662 |
|
14 |
14 |
$85.84 |
| 86580 |
|
24 |
24 |
$76.67 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
14 |
$0.00 |