| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,766 |
1,360 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
819 |
702 |
$28K |
| 99215 |
Prolong outpt/office vis |
64 |
48 |
$4K |
| 99199 |
Unlisted special service, procedure or report |
1,135 |
1,100 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
28 |
$466.29 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
38 |
$249.55 |
| 90688 |
|
52 |
46 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
14 |
$0.00 |