| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,902 |
3,215 |
$28K |
| 90686 |
|
157 |
149 |
$729.18 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
66 |
$357.81 |
| 93000 |
|
157 |
123 |
$355.59 |
| G0008 |
Administration of influenza virus vaccine |
100 |
99 |
$67.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
26 |
$23.60 |
| S9999 |
Sales tax |
16 |
12 |
$0.00 |
| 3078F |
|
14 |
14 |
$0.00 |
| 1159F |
|
14 |
14 |
$0.00 |
| 1160F |
|
14 |
14 |
$0.00 |
| 1124F |
|
14 |
14 |
$0.00 |
| 1036F |
|
39 |
39 |
$0.00 |
| 36416 |
|
25 |
24 |
$0.00 |
| 3074F |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
58 |
58 |
$0.00 |
| 1170F |
|
14 |
14 |
$0.00 |
| 1101F |
|
14 |
14 |
$0.00 |