| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,651 |
3,108 |
$190K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,628 |
2,271 |
$82K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
111 |
92 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
78 |
65 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
14 |
$789.74 |
| 99336 |
|
21 |
13 |
$326.40 |
| 90756 |
|
17 |
17 |
$146.30 |
| 99334 |
|
15 |
12 |
$103.32 |
| 90688 |
|
23 |
20 |
$63.20 |
| G0008 |
Administration of influenza virus vaccine |
16 |
13 |
$0.00 |