| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
628 |
541 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
103 |
100 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$341.05 |
| 90686 |
|
12 |
12 |
$139.56 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
45 |
$9.90 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
40 |
40 |
$0.00 |
| 3725F |
|
34 |
34 |
$0.00 |
| 3078F |
|
34 |
34 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
17 |
17 |
$0.00 |
| 3074F |
|
20 |
20 |
$0.00 |