| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,655 |
1,595 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,084 |
1,040 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
46 |
$3K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
33 |
25 |
$1K |
| 99205 |
Prolong outpt/office vis |
14 |
14 |
$1K |
| 90686 |
|
53 |
53 |
$834.64 |
| 96156 |
|
15 |
15 |
$730.33 |
| 81003 |
|
139 |
112 |
$131.49 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
55 |
$103.50 |
| 98960 |
|
26 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
24 |
24 |
$0.00 |
| 1000F |
|
13 |
13 |
$0.00 |