| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
199 |
191 |
$8K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
25 |
24 |
$2K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
27 |
26 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
21 |
19 |
$821.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$224.41 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
13 |
$94.20 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
63 |
62 |
$0.00 |
| 1160F |
|
13 |
12 |
$0.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
65 |
63 |
$0.00 |