| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,116 |
1,607 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,952 |
1,508 |
$73K |
| 99199 |
Unlisted special service, procedure or report |
2,866 |
2,865 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
181 |
122 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
117 |
85 |
$1K |
| 99442 |
|
16 |
15 |
$361.58 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$267.53 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
12 |
$224.95 |
| 36415 |
Collection of venous blood by venipuncture |
133 |
112 |
$218.70 |
| 90688 |
|
29 |
24 |
$81.75 |
| 99173 |
|
27 |
14 |
$1.00 |
| 2000F |
|
190 |
157 |
$0.00 |
| 2010F |
|
196 |
175 |
$0.00 |
| 3008F |
|
156 |
142 |
$0.00 |
| 1159F |
|
208 |
186 |
$0.00 |
| 3028F |
|
91 |
81 |
$0.00 |
| 92552 |
|
16 |
12 |
$0.00 |