| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,267 |
1,200 |
$112K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
780 |
736 |
$51K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
109 |
109 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19 |
14 |
$853.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$440.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$238.42 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$191.36 |
| 96160 |
|
108 |
108 |
$0.00 |