| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99385 |
|
103 |
97 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
74 |
74 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
118 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
51 |
51 |
$3K |
| 99205 |
Prolong outpt/office vis |
37 |
37 |
$3K |
| 99215 |
Prolong outpt/office vis |
31 |
30 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$332.64 |
| 90674 |
|
12 |
12 |
$272.97 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$48.62 |