| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99454 |
|
617 |
617 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,060 |
1,027 |
$6K |
| 99457 |
|
528 |
528 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
840 |
708 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
809 |
795 |
$288.14 |
| 90662 |
|
118 |
118 |
$21.68 |
| G0008 |
Administration of influenza virus vaccine |
120 |
120 |
$12.44 |
| 99497 |
|
27 |
27 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
26 |
26 |
$0.00 |
| 93000 |
|
12 |
12 |
$0.00 |