| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99349 |
|
609 |
582 |
$46K |
| 90715 |
|
788 |
784 |
$24K |
| 90688 |
|
1,250 |
1,229 |
$20K |
| 90632 |
|
298 |
294 |
$16K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,999 |
1,946 |
$14K |
| 80305 |
|
1,537 |
1,314 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
507 |
453 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,591 |
1,548 |
$10K |
| 90686 |
|
472 |
469 |
$9K |
| 84703 |
|
1,085 |
1,013 |
$6K |
| 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 |
101 |
88 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
107 |
$5K |
| 96160 |
|
337 |
336 |
$4K |
| 0011A |
|
168 |
168 |
$4K |
| 90756 |
|
122 |
122 |
$3K |
| 81002 |
|
1,156 |
1,095 |
$3K |
| 0012A |
|
80 |
80 |
$2K |
| 86580 |
|
534 |
499 |
$2K |
| 0064A |
|
20 |
20 |
$750.92 |
| 0004A |
|
17 |
17 |
$638.01 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
100 |
83 |
$637.00 |
| 0031A |
|
23 |
23 |
$589.51 |
| 93000 |
|
60 |
60 |
$477.90 |
| 36415 |
Collection of venous blood by venipuncture |
164 |
159 |
$364.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$328.56 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
24 |
$186.76 |
| 80354 |
|
305 |
266 |
$0.00 |
| 98968 |
|
12 |
12 |
$0.00 |