| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,050 |
1,737 |
$132K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,370 |
1,225 |
$60K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,894 |
1,894 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
40 |
$831.48 |
| 90686 |
|
35 |
34 |
$425.75 |
| S0315 |
Disease management program; initial assessment and initiation of the program |
36 |
36 |
$270.00 |