| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
171 |
140 |
$219.72 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
14 |
$0.00 |
| 81002 |
|
14 |
12 |
$0.00 |
| 99000 |
|
64 |
50 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
13 |
$0.00 |
| 90686 |
|
16 |
16 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
50 |
46 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
14 |
14 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
15 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
35 |
33 |
$0.00 |
| 36416 |
|
40 |
36 |
$0.00 |