| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
487 |
471 |
$1K |
| 88150 |
|
25 |
25 |
$495.00 |
| 90686 |
|
17 |
17 |
$360.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
19 |
$127.70 |
| 3074F |
|
65 |
65 |
$0.00 |
| 99000 |
|
80 |
79 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
16 |
16 |
$0.00 |
| 3079F |
|
14 |
14 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
16 |
16 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |