| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112 |
103 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
16 |
$1K |
| 90670 |
|
16 |
16 |
$176.00 |
| 90680 |
|
12 |
12 |
$132.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
14 |
14 |
$0.00 |
| 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) |
22 |
16 |
$0.00 |
| 96161 |
|
15 |
15 |
$0.00 |