| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
231 |
230 |
$408.43 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
447 |
423 |
$395.28 |
| 90686 |
|
79 |
79 |
$50.00 |
| 92551 |
|
56 |
56 |
$22.04 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
55 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
217 |
216 |
$0.00 |
| 90656 |
|
53 |
53 |
$0.00 |