| Code | Description | Claims | Beneficiaries | Total Paid |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
64 |
64 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
90 |
90 |
$5K |
| 99222 |
Initial hospital care, per day, moderate complexity |
28 |
26 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$803.92 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$585.59 |