| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
151 |
139 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
74 |
$835.11 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
81 |
47 |
$635.04 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
12 |
$122.10 |
| 1036F |
|
35 |
35 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
13 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
121 |
112 |
$0.00 |
| 90686 |
|
19 |
19 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
106 |
99 |
$0.00 |
| 3288F |
|
12 |
12 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
12 |
12 |
$0.00 |