| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 41899 |
Unlisted procedure, dentoalveolar structures |
2,606 |
1,723 |
$660K |
| 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 |
2,597 |
2,151 |
$286K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,172 |
2,015 |
$138K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
522 |
500 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
889 |
874 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
105 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
98 |
91 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
206 |
178 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
290 |
286 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$3K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new 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 |
32 |
25 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
122 |
121 |
$235.96 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$155.40 |
| 85018 |
|
14 |
14 |
$24.30 |
| 99177 |
|
48 |
48 |
$0.47 |
| 2001F |
|
209 |
195 |
$0.00 |
| 2000F |
|
109 |
105 |
$0.00 |
| 3008F |
|
209 |
195 |
$0.00 |
| 2010F |
|
211 |
197 |
$0.00 |
| 90686 |
|
375 |
373 |
$0.00 |
| 3074F |
|
80 |
79 |
$0.00 |
| 1036F |
|
14 |
12 |
$0.00 |
| 3078F |
|
92 |
91 |
$0.00 |
| 90461 |
|
99 |
99 |
$0.00 |
| 99173 |
|
151 |
150 |
$0.00 |
| 1159F |
|
64 |
60 |
$0.00 |
| 1160F |
|
64 |
60 |
$0.00 |
| 4274F |
|
32 |
32 |
$0.00 |