| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
306 |
259 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$980.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$980.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
14 |
$210.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17 |
13 |
$182.34 |
| G8783 |
Normal blood pressure reading documented, follow-up not required |
50 |
44 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
19 |
12 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
16 |
12 |
$0.00 |