| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92081 |
|
1,151 |
1,110 |
$39K |
| 90686 |
|
1,746 |
1,642 |
$35K |
| 92552 |
|
776 |
775 |
$14K |
| 90682 |
|
197 |
197 |
$13K |
| 90750 |
|
77 |
77 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
163 |
163 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,133 |
2,107 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
103 |
63 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
95 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,781 |
4,589 |
$4K |
| 90688 |
|
245 |
245 |
$4K |
| 90658 |
|
195 |
195 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
398 |
396 |
$4K |
| 90656 |
|
105 |
105 |
$2K |
| 90662 |
|
62 |
62 |
$2K |
| 90756 |
|
47 |
47 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$1K |
| 90673 |
|
16 |
16 |
$795.04 |
| 90657 |
|
39 |
39 |
$450.45 |
| 90655 |
|
14 |
14 |
$427.14 |
| 86580 |
|
27 |
26 |
$88.80 |
| G0008 |
Administration of influenza virus vaccine |
17 |
17 |
$34.69 |
| 3074F |
|
12 |
12 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
132 |
131 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
129 |
128 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
76 |
76 |
$0.00 |
| 69210 |
|
12 |
12 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |