| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68 |
62 |
$683.13 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
59 |
$673.13 |
| 90686 |
|
27 |
14 |
$391.59 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
13 |
$382.85 |
| 99000 |
|
35 |
32 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
17 |
15 |
$0.00 |