| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90756 |
|
30 |
29 |
$280.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
901 |
844 |
$271.58 |
| 3008F |
|
1,105 |
1,036 |
$79.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
27 |
26 |
$45.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$40.00 |
| 96160 |
|
391 |
390 |
$0.00 |
| G9920 |
Screening performed and negative |
28 |
28 |
$0.00 |
| 3078F |
|
61 |
57 |
$0.00 |
| 3725F |
|
77 |
77 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
61 |
61 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
27 |
27 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
55 |
55 |
$0.00 |
| 3074F |
|
80 |
77 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
13 |
12 |
$0.00 |