| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
55 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
87 |
87 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
179 |
178 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
76 |
69 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
246 |
242 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
35 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
45 |
45 |
$3K |
| 86580 |
|
122 |
119 |
$1K |
| 90688 |
|
130 |
130 |
$814.32 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
25 |
25 |
$327.46 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
16 |
16 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |