| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,416 |
1,307 |
$163K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,788 |
1,606 |
$140K |
| 96156 |
|
218 |
216 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
14 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$684.00 |
| 96151 |
|
25 |
25 |
$438.66 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$264.00 |
| 90686 |
|
33 |
33 |
$203.49 |
| 99050 |
|
13 |
13 |
$180.00 |
| 92551 |
|
12 |
12 |
$161.52 |
| 90657 |
|
13 |
13 |
$120.00 |
| 3008F |
|
100 |
100 |
$0.00 |