| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
932 |
868 |
$71K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
25 |
$877.41 |
| 96127 |
|
72 |
70 |
$599.14 |
| 81002 |
|
255 |
247 |
$535.94 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$180.00 |
| 90688 |
|
12 |
12 |
$108.00 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14 |
13 |
$85.70 |