| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
204 |
203 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$884.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$757.27 |
| 90686 |
|
12 |
12 |
$360.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
14 |
14 |
$161.14 |