| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
202 |
199 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
331 |
317 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
383 |
367 |
$15K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
67 |
67 |
$12K |
| 95117 |
|
670 |
228 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
90 |
87 |
$6K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
27 |
27 |
$4K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
13 |
13 |
$3K |
| 95115 |
|
70 |
25 |
$574.24 |