| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,416 |
641 |
$62K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
15 |
$664.53 |
| 99199 |
Unlisted special service, procedure or report |
55 |
53 |
$209.96 |
| 81002 |
|
105 |
81 |
$135.45 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
13 |
$53.20 |
| 36415 |
Collection of venous blood by venipuncture |
60 |
15 |
$24.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
217 |
83 |
$0.00 |
| 90686 |
|
85 |
13 |
$0.00 |