| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
80 |
74 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
68 |
66 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
35 |
35 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
15 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 99381 |
|
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
102 |
99 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
46 |
46 |
$724.00 |
| 97802 |
|
33 |
33 |
$134.01 |
| 94760 |
|
45 |
45 |
$27.24 |
| 36416 |
|
13 |
13 |
$8.40 |
| 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) |
46 |
44 |
$0.00 |
| 90670 |
|
19 |
19 |
$0.00 |
| 90648 |
|
18 |
18 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
62 |
46 |
$0.00 |
| 96160 |
|
36 |
34 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
114 |
110 |
$0.00 |
| G8432 |
Depression screening not documented, reason not given |
17 |
15 |
$0.00 |
| 87650 |
|
16 |
16 |
$0.00 |
| 85018 |
|
14 |
14 |
$0.00 |
| 99174 |
|
33 |
33 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |