| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
395 |
325 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
340 |
297 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
430 |
351 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$951.95 |
| 90686 |
|
27 |
27 |
$359.50 |
| 93000 |
|
17 |
17 |
$150.28 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
17 |
$136.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$96.00 |
| 81002 |
|
18 |
13 |
$20.16 |