| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,387 |
2,286 |
$107K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
185 |
180 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
25 |
25 |
$968.00 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$601.02 |
| 90682 |
|
17 |
14 |
$498.51 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
22 |
22 |
$276.00 |
| 92551 |
|
12 |
12 |
$44.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
504 |
503 |
$0.00 |
| 90674 |
|
32 |
32 |
$0.00 |
| 90673 |
|
12 |
12 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
12 |
12 |
$0.00 |
| 90661 |
|
15 |
15 |
$0.00 |