| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
742 |
645 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
121 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44 |
39 |
$685.35 |
| 90686 |
|
12 |
12 |
$165.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
12 |
$80.50 |
| 81002 |
|
15 |
13 |
$9.08 |
| 1159F |
|
285 |
238 |
$0.00 |
| 96160 |
|
27 |
27 |
$0.00 |
| 3078F |
|
71 |
62 |
$0.00 |
| 1158F |
|
36 |
36 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
593 |
517 |
$0.00 |
| 1123F |
|
36 |
36 |
$0.00 |
| 3079F |
|
31 |
28 |
$0.00 |
| 3074F |
|
74 |
65 |
$0.00 |